Relational Depth

New Perspectives and Developments

Rosanne Knox, David Murphy, Susan Wiggins

• Publisher: Bloomsbury Academic
• Year: 2012
• ISBN:
  9781350305533
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

This wide-ranging textbook offers a fascinating survey of the latest thinking and research on in-depth therapeutic encounters by bringing together the latest theory, research and practice on working at relational depth with clients in counselling and psychotherapy. By exploring the meaning, challenges and experiences of relational depth, it provides insight into an important dimension of therapeutic practice and, for many, will act as a guide to new ways of thinking about their therapeutic relationships. This book is an essential read for all trainees and practitioners in counselling and psychotherapy who want to deepen their levels of therapeutic relating.

PART I

Experience and Evidence of Relational Depth

1.	Meeting at relational depth in therapy: the lived encounter Chris Brown, Anne Deacon, Jan Kerr and Kenny Ralph
2.	Relational depth from the client’s perspective Rosanne Knox
3.	Therapists’ experiences of relational depth with clients with learning disabilities Eleanor Macleod
4.	Assessing relational depth: developing the Relational Depth Inventory Sue Wiggins
5.	Experiencing relational depth in therapy: what we know so far Mick Cooper

1

Meeting at relational depth in therapy: the lived encounter

Chris Brown, Anne Deacon, Jan Kerr and Kenny Ralph

For counsellors and psychotherapists, the experience of meeting a client at relational depth in therapy can be a profound and memorable experience, which has the potential to impact deeply on the therapeutic relationship and the client’s psychological development. In this chapter, we explore the experiences and evidence of relational depth by presenting four therapists’ accounts of meeting clients at this level of engagement. The aim is to bring the phenomenon of relational depth, as actually lived and experienced, to the fore, and to begin to develop an understanding of its nature and impact.

All accounts are written with the kind permission of the clients or, in the case of Tony, with his family. Clients’ names are pseudonyms. Each of the therapists identify as person-centred practitioners, with substantial experience of working with a range of clients.

Grace (by Anne Deacon)

Grace was physically and mentally abused from a young child to her leaving home at 16 years old. She was beaten on a regular basis for anything and everything. Her meal would be put on the table at the same time as those of her mother, father and sister but she wouldn’t be allowed to eat it until they had finished and had left the table; consequently, her food was always cold, and sometimes so inedible that she would want to be sick and she would be flung out of the back door, whatever the weather, to be sick in the drain.

Her mother taught her to spell her name wrong so she would be humiliated at school. Christmas was a terrible time for her, she never received a present but had to sit and watch her sister opening hers. Grace learned early in her life to keep her feelings under control and never show any emotion. Every waking moment was fearful for her as she never knew what might provoke another attack.

She came to me for counselling when she was 39 years old. She said that she wanted to find a way to have a better life. I counselled Grace for over two years. Grace struggled to understand what feelings felt like because she had never had the luxury of experiencing any. Even fear had been replaced by a void of nothingness. We worked for many months trying to recognize feelings and giving them the appropriate names.

There were many times when Grace’s only means of understanding how unacceptable events in her life had been was through my deep empathy. Many times I would physically feel her pain and anguish and my expression and body language reflected this, and thus through my congruence during these situations, Grace was able to draw from me the enormity of what she had endured.

Then came the day when she was telling me of yet another beating and as my eyes filled with tears as I listened, she suddenly stopped mid-sentence and said to me: ‘those tears should be mine, shouldn’t they?’ I nodded, Grace continued to look at me and then I saw her eyes begin to fill with tears as well. (This was the first time in 18 months that she had shown emotion.) She continued to look at me as if she needed to be connected to my tears to allow hers to flow. Time seemed to stand still, quietness had seemed to descend on the room, there was nothing happening, yet there was so much happening, Grace continued to look at me and the enormity of her pain was tangible. Then her tears came, slowly at first, as she blinked hard as if to force them out of her eyes. Then she was sobbing, her body shaking with the force. She looked at me now with panic in her eyes as she experienced for the first time what it felt like to cry for herself. I leaned closer, her tears were now falling onto her arms and clothes and the noises she made came from deep within her very soul.

I asked softly if she wanted me to sit next to her, she nodded, so I moved slowly across to the settee and sat down half-facing her (touch was something she was afraid of, so I needed to be extremely sensitive) and then made my hand available to her. It seemed a while before she very slowly moved her hand towards mine. I made no movement and gradually she touched my finger with hers. All the while her sobbing continued. Suddenly I was aware she was carefully and gently starting to hold my finger.

When I felt her finger touching mine, I was careful not to make much movement as I was aware of the courage it was taking for her to touch me. The way she was touching me was so tentative and uncertain that instinctively I didn’t respond straightaway, but waited until she was holding my finger more securely. Then, very slowly, I held her back and we sat like that for what seemed an eternity. The contrast between her fragile touch and her racking sobs seemed a chasm apart.

I didn’t feel any sense of a need to comfort her in any way, I felt a deep empathy for her and in that moment I was willing to just sit alongside her in that dreadfully painful and terrifying place she now found herself in. (In the past, to cry would have resulted in a beating.) She was not only crying for the first time but she was touching another human being, and to me, in that moment, she was saying: ‘I trust you with my tears and with my touch.’

My chest cavity was full to the brim with emotion and it felt difficult to breath. I no longer felt any desire to cry for her pain. But the effort of just staying close was intense.

Eventually, her crying subsided. Just as gently and slowly as she had first held my finger, she now began to release it and, as if in slow motion, we took up our original positions facing each other. She looked into my eyes again and in that moment we both knew that something truly wondrous had just taken place.

Tony (by Kenny Ralph)

I started working as a support worker about seven years ago. One month into the job I met Tony. Tony was in his mid-twenties and has cerebral palsy and profound learning difficulties; he communicates through hand and eye pointing and vocalizations that indicate either contentment or distress. Touch is also a form of communication for Tony. He likes to hold hands; if he is tense, or agitated, he may well twist the thumb of the hand he is holding.

As I got to know Tony, I became struck, and was surprised, by the level of intimacy and intensity that I often felt occurred during our interactions. Tony really enjoys his food and so meal-times provide a great opportunity for interaction. It was not at all uncommon for Tony to reach out after he finished eating to give me a hug. These hugs were quite special; it may sound strange but they felt so genuine, they felt like more than just hugs. I noticed other forms of expression that seemed more powerful when they came from Tony. If the two of us were playing with toys on the floor, our eyes might meet and Tony would really hold that eye contact; again, it felt like more than just eye contact. It felt like an exchange of information or data, like two mainframes swapping files. I can’t put into precise words what ‘information’ was ‘swapped’, but, generally, I felt a shared sense of gratefulness and a genuine warmth, something very close to love, and a tangible bond.

I labelled these exchanges (because an exchange is what I experienced) as moments of ‘pure communication’, or what has also been called ‘relational depth’. I remember one of these moments particularly well. One night I was woken by Tony’s laughter. This in itself was not unusual; Tony sometimes got out of bed and may have found something to amuse himself with. I entered his room, expecting to find him on the floor, but to my surprise he was lying in his bed. I didn’t know what he was laughing at. Usually, I would have turned, walked out of the room and gone back to bed but Tony had spotted me. He propped himself up on his elbow, still laughing, looked at me and held out his hand. This was Tony’s way of calling me over. I took hold of his hand and knelt on the floor next to his bed. By now I was also laughing; it is very funny to be in someone’s company when they are in hysterics. We stayed like that for several minutes, just laughing together. I wasn’t his support worker at that moment; it didn’t matter that we should both be sleeping or that we would pay for this the next morning. At some point, it became more than just laughing, it felt like sharing bits of our selves. Looking back, I get such a strong sense of his being alive, there was so much energy pouring from him, like sunlight through a crack in the curtains. Usually, if Tony was feeling particularly boisterous, he would try to initiate more interaction: for example, he might try to hug me or perhaps get out of bed. But this time he did none of these things, he was happy just to lie where he was, laughing and holding my hand. Somewhere along the line, I stopped laughing at how funny it was to see Tony in hysterics; now I was laughing with Tony, like he had made me see his point of view, and he was grateful that I had got it. After ten minutes or so our laughter tapered off and we held each other’s stare and smiled. It was when we were looking at each other’s eyes that I got the sense of pure communication. It was like our laughter had been part of a journey and when we stopped and looked up we realized that we’d reached an oasis. Everything was peaceful and still. At some point, Tony started to drift off and I left him and went back to bed.

When I look back and attempt to describe what happened for me during that exchange, I struggle. I know I felt a shared warmth and appreciation. I am not able to say what thoughts were going through my head and I think that is because these examples have happened when I am ‘in the moment’. I am not consciously processing what is happening to me during these interactions and feel quite certain that if I did try to examine them on any level, as they happened, then that moment would come to an abrupt end.

It is important to point out that the majority of our interaction was not as powerful as the examples I have given. Sometimes Tony was not in the mood and sometimes I was not. Either way, we both had to be present for these exchanges to occur. Also, these exchanges were not always ‘positive’. One time, Tony held my eyes as he cried and a feeling of sorrow came over me. We ended up crying together. Looking back, I would say it was a therapeutic experience.

Claire (by Jan Kerr)

A year after qualifying, I approached a local cancer support centre and asked whether they had a requirement for a counsellor; having volunteered for several years within a hospice, I felt drawn to working with this particular client group. I was fortunate that the manager was open to my suggestion and a few weeks later I began counselling with them.

My first experience of following a client’s journey through her partner’s illness, his death, and the ensuing months until she was ready to re-engage with life fully was also my first experience of connecting at relational depth with a client. We worked together for a total of 24 sessions over a period of 12 months, and during this time we often experienced specific moments of encounter within a relationship that held a particular quality from the very first session together.

Claire, an open and articulate woman in her mid-fifties, called into our drop-in centre. After a discussion with a support worker, she arranged to meet me, despite stating that she did not want to ‘waste’ my time. Claire’s husband, Stephen, had been treated successfully for cancer nearly two years earlier. It had come as a total shock a few weeks ago when they discovered that the cancer had returned, with no hope of recovery. The deterioration in his health during these recent weeks had been very rapid and neither was prepared for the enormity of the situation. They shared a close family unit and their six children were leaning on Claire for support. Coping with daily hospital visits, family commitments and the responsibility of working full time was now becoming stressful for Claire.

During our first meeting, Claire shared her story with me and I was aware that I was feeling a deep sorrow and compassion for her. She believed she was coping well. She spoke of balancing work, hospital visits, the concern of family and friends, Stephen’s imminent return home to die – all of this as if there was no effort involved. I was struck by a sense of this woman being weighed down by the enormity of her situation. She acknowledged that although it was difficult, she was ‘managing fine – after all, it is not me who has cancer’. I felt deeply moved and said gently: ‘I hear that you are coping and that you are also supporting everyone but I am wondering who looks after you?’ She looked at me for a few moments saying nothing, then tears began to flow down her cheeks as she sobbed uncontrollably.

As she cried, I sat quietly with tears in my eyes, not moving in to change anything so that Claire’s flow was not interrupted nor impeded by me. As Claire’s sobs subsided, she smiled at me and said: ‘You know, that’s the first time I’ve cried. Thank you.’ I smiled back and said ‘I’m glad’ and for the next few mom...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Foreword
• Acknowledgements
• Introduction: the in-depth therapeutic encounter
• Part I: Experience and Evidence of Relational Depth
• Part II: Relational Depth in Context
• Part III: Related Perspectives
• Index