This slideshow is part of the materials for a module on psychotherapy integration, on the basis of relational modalities and diverse and multiple relational spaces. This addresses the traditional paradigm clashes between the humanistic and psychodynamic traditions (as well as between the humanistic approaches and the ‘medical model’), working towards a paradoxical integration.
Here I am proposing a spectrum of different relational spaces, and the corresponding stances that a therapist might take and the roles they would therefore inhabit.
At one end of the spectrum - as championed by the humanistic tradition - the therapeutic relationship is conceived of as an existential co-explorative encounter between two equal human beings; at the far other end of the spectrum the therapeutic relationship fits the 'medical model' and falls into an expert 'treatment' paradigm. The psychodynamic tradition sits ambiguously in between, depending on what historical period in the development of psychoanalysis and which psychoanalytic school we emphasise.
I am implying that both ends of the spectrum (and any position in between) can be experienced by clients as helpful and therapeutic some of the time and is therefore a valid relational therapeutic modality, forming one of the foundations for psychotherapy integration.
This model is an elaboration of Petruska Clarkson's multiplicity of relational modalities.
This version of the presentation includes some additional slides, formulated for Gestalt as well as Body Psychotherapists, as well as one slide summarising Lavinia Gomez's warning regarding the limitations of integration between humanistic and psychodynamic traditions.
2. space for joint exploration authoritative space
being an expert
being an equal
being genuinely
helpful
from within &
through a role
being powerfully
helpful through
authentic relating
as a person
varieties of authority
incl. ‘one-person
psychology’
& ‘treatment’ (‘I’ - ‘it’)
dialogical
person-to-person
relating
‘I’ - ‘I’ (or ‘I-Thou’)
3. space for joint exploration authoritative space
being an expert
being an equal
being powerfully helpful
through authentic relating
as a person:
privileging spontaneous
responses & interaction for the
sake of trustworthy immediacy &
transparency
being genuinely helpful
from within & through a
role:
privileging reflectiveness &
deliberateness for the sake of
containment & effectiveness and
holding boundaries & frame
dialogical
person-to-person
relating
‘I’ - ‘I’ (or ‘I-Thou’)
varieties of authority
incl. ‘one-person
psychology’
& ‘treatment’ (‘I’ - ‘it’)
therapist in tension/
conflict between:
being a person and
a professional role
being spontaneous and
reflective/deliberate/strategic
two-person and
one-person psychology
4. space for joint exploration authoritative space
being an expert
being an equal
being powerfully
helpful through
authentic relating
as a person
being genuinely
helpful
from within &
through a role
dialogical
person-to-person
relating
‘I’ - ‘I’ (or ‘I-Thou’)
varieties of authority
incl. ‘one-person
psychology’
& ‘treatment’ (‘I’ - ‘it’)
∞
enduring & embracing the
tension between polarities
= the conflicted diversity &
multiplicity of relational
stances and spaces
= surrendering to conflict
being an ambiguous,
contradictory, conflicted,
paradoxical mixture
5. space for joint exploration authoritative space
being an expert
being an equal
RELATIONSHIP TREATMENT
being paradoxical mixture
useless,
disappointing equal
‘anti-medical’ model
potentially collusive
too merged - avoid separateness
deny difference
negative authority
(power-over)
inwardly & outwardly defensive
potentially objectifying
too separate /avoid merger
deny sharedness
‘medical’ model’
shared humanity
(power-with)
benign authority
(facilitative power)
empowering
potentially helpful practitioner
(someone who gets paid for love)
ambiguous, conflicted, paradoxical relationship
humanistic psychodynamic doctor
friend
c
o
l
l
u
s
i
o
n
c
o
m
p
l
i
a
n
c
e
6. space for joint exploration authoritative space
being an expert
being an equal
humanistic psychodynamic doctor
friend
c
o
l
l
u
s
i
o
n
c
o
m
p
l
i
a
n
c
e
collusion
with friend:
avoidance and
denial of
difference &
power
differential
therapist in tension/conflict between:
being a person and a professional role
compliance
with expert:
patterns of
imposition
obedience and
hidden
rebellion
helpful human meeting
core conditions: unconditional regard, empathy, congruence
expert help / treatment
neutrality, objectivity, lack of subjective investment
psychodynamic
allowing oneself to be constructed
7. space for joint exploration authoritative space
being an expert
being an equal
RELATIONSHIP TREATMENT
collusive
friend
older
sibling
friend
uncle /
aunt
head
master
traditional
family
doctor
fairy god-
parent
step
parent
doctor
spectrum of potentially helpful stances and relational spaces
8. space for joint exploration authoritative space
being an expert
being an equal
humanistic psychodynamic doctor
friend
being the same being an ‘other
IDENTIFYING & EMPATHISING BEING SEPARATE & DIFFERENTIATED
core conditions are inherently in tension with each other
tension between focus on other versus focus on self
friend - empathy & regard (UPR) congruence - authority
9. space for joint exploration authoritative space
being an expert
being an equal
humanistic psychodynamic doctor
friend
IDENTIFYING & EMPATHISING
being ‘alongside’ based upon
fundamental human sameness
BEING SEPARATE & DIFFERENTIATED
being ‘opposite’ by being a relational ‘other,
based upon being different
collapsing
sameness into
collusive friend
unconditional
regard:
a warm, attuned
presence via
compassionate
resonance
congruence:
being a separate,
different
dialogical
relational ‘other’
collapsing
difference into
dualistic
categorical
otherness
neutral authority:
holding firm,
containing
boundaries of
difference
being an
ambiguous,
contradictory
mixture
fluid authority:
being a
facilitative
benign but
different
relational ‘other’
psychoanalysis:
allowing oneself to be constructed as a transferential ‘other’
empathy:
being a
supportive ally
based on
identification
10. space for joint exploration authoritative space
being an expert
being an equal
humanistic psychodynamic doctor
friend
IDENTIFYING
&
EM
PATHISING
BEING
SEPARATE
&
DIFFERENTIATED
collusive
relationship
with ’friend'
objectifying
treatment
by 'doctor'
12. space for joint exploration authoritative space
being an expert
being an equal
being powerfully
helpful through
authentic dialogical
relating as a person
being genuinely
helpful
from within &
through a role
phenomenological
exploration of person-to-
person relating
‘two-person psychology’
‘I’ - ‘I’ (or ‘I-Thou’)
varieties of authority &
role relating incl.
‘one-person psychology’
& ‘treatment’ (‘I’ - ‘it’)
13. space for joint exploration authoritative space
being an expert
being an equal
RELATIONSHIP TREATMENT
useless,
disappointing equal
shared humanity
(power-with)
benign authority
(facilitative power)
empowering
negative authority
(power-over)
inwardly & outwardly defensive
potentially collusive
too merged - avoid separateness
deny difference
potentially helpful practitioner
(someone who gets paid for love)
potentially objectifying
too separate /avoid merger
deny sharedness
‘anti-medical’ model ambiguous, conflicted, paradoxical relationship ‘medical’ model’
being paradoxical mixture
collusion com
pliance
humanistic / Gestalt
(phenomenology, field theory,
attention to present moment)
psychodynamic doctor
friend
Gestalt integrating psychodynamic principles
(eg Lynne Jacobs & Peter Phillipson)
a dialogical equal
14. space for joint exploration authoritative space
being an expert
being an equal
RELATIONSHIP TREATMENT
collusive
friend
interactive
bodymind
regulator of
trauma
phenomenological
co-explorer
reparative
parent -
good
mother/
father
classical
Reichian
functional
-ist expert
spiritual
bodymind
guide
fairy god-
parent
embodiment
or
mindfulness
educator
doctor
one-person psychology
one-and-a-half-person
two-person psychology
spectrum of potentially helpful stances and relational spaces
15. space for joint exploration authoritative space
being an expert
being an equal
humanistic psychodynamic doctor
friend
relational position: "ALONGSIDE"
being an ally / being on client's side /
champion client’s self-actualisation process
relational position: "OPPOSITE"
an 'other' / a relational other
champion client’s individuation process
Lavinia Gomez:
'Humanistic or psychodynamic - what is the difference and do we have to make a
choice ?' Self & Society Vol. 31 No.6 Feb/Mar 2004, p. 5 - 19
Gomez’s challenge to humanistic-psychodynamic integration:
Once the transference has been constellated (whether or not through the therapist
inviting it by taking an ‘opposite’ position), we are NOT free to switch back arbitrarily
into an ‘alongside’ position, as this will then be (mis-)perceived by the client’s
unconscious through the transference (as an avoidance of the wounding dynamic and its
heat/intensity/difficulty). Any such switching is therefore liable to acquire unintended
transferential meanings (i.e. that the therapist cannot bear it, either, and thus undermine
‘containment’ and the working alliance.
