What should be the relationship between the therapist and the client, who is responsible for the result and what to do if I do not trust anyone.
What is Therapeutic Alliance
When seeking help, we focus primarily on the experience and competence of a specialist. Psychotherapy is a process in which the personality of the therapist and his relationship with the client also play an equally important role. It is important to be clear: this is not about friendships, romantics, or even business relationships. It is a relationship based on trust, empathy and a common goal – to solve the client’s problem and make his life better. It is called “psychotherapeutic alliance”.
Numerous studies have shown that the presence of a psychotherapeutic alliance positively affects the results of therapy. Opening up to a stranger, talking about your feelings and traumas is stressful for any person. The atmosphere of acceptance and support, the active participation of the therapist helps most clients cope better with it. For many, this even becomes the first experience of open and trusting relationships. In itself, building a therapeutic alliance can change the quality of life.
How to Understand if the Alliance is Forming: Check-List
Listen to your feelings. According to client surveys, the psychotherapeutic alliance is perceived as:
- Feeling that the therapist cares about what happens in and out of the session;
- Warm, sympathetic attitude from the therapist;
- Feeling that you are understood;
- Feeling of cooperation and working towards a common goal;
- An atmosphere in which you can be yourself, not hide emotions and express yourself openly.
You may not have checked all the points for yourself – this is normal at the beginning of therapy. It will take time for both you and the therapist to build that connection. The speed can be reduced by negative past experiences, internal attitudes (for example, “you can’t express emotions in public”), or just character traits: it’s easy for someone to make contact right away, and for some it takes more time. Please note that both parties are working on building a psychotherapeutic alliance. Despite the fact that the specialist has developed empathy and professional intuition over the years, without the cooperation of the client, a miracle will not happen. So ask yourself how sincerely you are ready to interact.
Nothing Works, What Should I Do?
Psychotherapy is a two-way process. If you feel that you are uncomfortable working, do not rush to change a psychologist – there may be several reasons for this.
Think about your own negative attitudes: do not the phrases “all psychologists are charlatans”, “I still can’t be helped”, “I can’t trust anyone” lie there? If any of this resonates within, you can bring it up for discussion at the next session. Openness is the first condition of a psychotherapeutic alliance, and working through doubts will advance you in building it.
Sometimes the therapist is unable to accurately determine your style of communication and behavior – this affects the nature of the therapeutic alliance. You may feel pressure from him that is not conducive to self-disclosure. Or perhaps you can’t find boundaries and feel like “everything is out of control.” Discuss this in the session and suggest changing the style of your interaction. Again, don’t be afraid to talk about your feelings, even if they’re negative. Feedback will help the therapist better understand you and the goals of psychotherapy.
If more than three sessions have already passed, but you feel that you are standing still, you may be talking about changing a psychotherapist. The main thing is not to be disappointed in psychotherapy and not to take the position of a victim. Take the active side and make a firm decision to improve your life – then in subsequent sessions you will definitely be able to create a strong psychotherapeutic alliance.
Therapeutic Alliance in Different Approaches
The notion of a psychotherapeutic alliance first appeared in psychoanalysis. Freud spoke of him in 1912. He believed that during psychoanalysis, the transfer mechanism can work: when the patient “transfers” the image of a significant person onto the figure of a psychoanalyst, starting to experience similar feelings for him. Freud wrote that a situation of “positive transference” can also arise in a session, when attachment and trust are formed between the patient and the analyst. Such relationships based on the here-and-now situation contribute to faster and more efficient work. They were later called the “working alliance” (Greenson, 1965).
In more recent approaches, the notion of a psychotherapeutic alliance has changed slightly. Its main components are cooperation, common purpose and trust.
This is especially evident in the client-centered approach of Carl Rogers. It is based on sincerity and empathy between all participants in psychotherapy. Unlike psychoanalysis, where the analyst is the main figure, here the client and therapist are on an equal footing. They create an alliance based on support and mutual openness. The client-centered direction suits people who find it difficult to express themselves; who have an internal block to demonstrate emotions. The therapist first shows the client that self-expression is safe.
The cognitive-behavioral approach deals with the solution of an actual problem here-and-now, without touching on deep feelings and childhood traumas. The task of the therapist is to help the client change his habitual reactions to more effective ones. The therapeutic alliance in this approach will be to create a free and calm atmosphere where it is easy for the client to behave naturally.
In existential analysis and logotherapy, the most important thing is the maximum disclosure of the client, the search for the self and the acquisition of meaning. This is what the alliance is working for: to explore the inner world together and find the way to a fulfilling life. The analyst accepts the client unconditionally – he does not condemn, does not evaluate and does not correct, but only helps to find himself.
Whichever approach you choose, without a psychotherapeutic alliance, the quality of therapy will be lower. Believe that this is a joint work, an alliance with common goals in which you take an active part. Isn’t it great to understand that you are the author of your life?