Relational Integrative Psychotherapy

Engaging Process and Theory in Practice

Linda Finlay

• Publisher: Wiley-Blackwell
• Year: 2015
• ISBN:
  9781119087328
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Designed specifically for the needs of trainees and newly-qualified therapists, Relational Integrative Psychotherapy outlines a form of therapy that prioritizes the client and allows for diverse techniques to be integrated within a strong therapeutic relationship.

• Provides an evidence-based introduction to the processes and theory of relational integrative psychotherapy in practice
• Presents innovative ideas that draw from a variety of traditions, including cognitive, existential-phenomenological, gestalt, psychoanalytic, systems theory, and transactional analysis
• Includes case studies, footnotes, 'theory into practice' boxes, and discussion of competing and complementary theoretical frameworks
• Written by an internationally acclaimed speaker and author who is also an active practitioner of relational integrative psychotherapy

1
What is Relational Integrative Psychotherapy?

Learn your theories as well as you can, but put them aside when you touch the miracle of the living soul. Not theories but your creative individuality alone must decide. (Jung, 1953, p. 73)

There are currently many different ways of doing relational integrative psychotherapy, a plurality fostered by a Zeitgeist which celebrates both the ‘relational’ and the ‘integrative’ dimensions of psychotherapy. Rather than rely on a single-school approach, with its specific theory and methods, psychotherapists are increasingly looking beyond traditional boundaries towards more holistic practice.

The variety of practice now available to us is not surprising, given our ability to draw upon more than 400 theories and models of psychotherapy (Norcross, 2005). This array testifies to the richness and dynamism of our field. While competing and contested approaches challenge our identity and often appear idiosyncratic and unconvincing, they also signal creativity, openness and respect for divergence. No blanket view or single technique can hope to embrace the complexity of human behaviour. We need to trawl widely to find therapy approaches which encompass both the individual and their social world and that engage intrapsychic, embodied, interpersonal, cultural and transpersonal levels (Norcross & Goldfried, 2005).

It’s probably true to say that much psychotherapy is relational and integrative at heart. If so, the convergence of these two movements may well rebalance an “over-fragmented field” (O’Brien & Houston, 2007, p. 4). In common with others, Markin (2014, p. 327) argues for a more “coherent and less polarizing professional identity”, noting that defining ourselves as coming from a particular modality sets up false dichotomies when, in practice, we routinely straddle multiple approaches.

This introductory chapter addresses the question, ‘What is relational integrative psychotherapy?’ The first two sections explore the concepts of relational and integrative, with the aim of providing an inclusive synthesising sketch while recognising some divergent voices. A third section discusses the challenges of integration we confront when practising in this relational integrative field. At the end of the chapter, a section titled ‘Concluding reflections’ begins a pattern for the rest of the book: I offer a conclusion of each chapter along with some personal thoughts and an implicit invitation to dialogue with me …

Being ‘Relational’

All therapists would probably concur that we humans are shaped by our social contexts and that our sense of who we are is intimately entwined with our relationships. Research consistently shows that, for people in general, close relationships are what matter most. When those relationships fail to give us what we need, we lose confidence. If relationships constitute the core of psychological problems, they can also be harnessed in the pursuit of growth and healing. Psychotherapy can be understood as fundamentally concerned with this relational context, in terms of past, present and future (see box 1.1).

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Box 1.1 Case illustration: Working relationally

Connie came into therapy to work on issues of intimacy in relationships after a string of problematic relationships with men. It emerged that Connie had been born addicted to heroin and had spent the first five years of her life living in random squats or on the streets with her neglectful mother, a substance abuser. Her mother remained toxic – both literally and figuratively – until Connie was taken into care and lost contact with her. She was eventually adopted by a solid nurturing family and had a reasonably good childhood. But damage had been done.

During therapy, every time the therapist became physically or emotionally close, Connie backed away. Together they recognised how Connie had learned to shut out others and close down her needs to avoid being abused and/or abandoned. The therapist attuned to Connie by progressing slowly, carefully, gently and in a respectful way. Over many months the therapist was consistently there for Connie, gradually decreasing the (emotional and physical) space between them. A significant moment of healing eventually occurred when Connie was able to cry while being held in the therapist’s arms.

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Within this general acceptance of the relational context of therapy, some practitioners promote the therapeutic relationship, rather than the individual client, as the primary focus of therapy.¹ This is the stance of this book. The basic argument is that as our only real access to another’s experiencing is through our relationship with the Other, that relationship must be our therapeutic vehicle. As Yalom declares in his much-quoted professional ‘rosary’: “It’s the relationship that heals, the relationship that heals, the relationship that heals” (1989, p. 91, emphasis mine).

Four key tenets are central to this committed relational approach:

• Therapy offers a microcosm. The therapeutic relationship lies at the centre of things, acting as a here-and-now microcosm of what clients experience in their social world. In this microcosm, the client’s relational being is disclosed (Spinelli, 2015).
• The significance of between. The mysterious intersubjective space between, where we touch and are touched by the Other in multiple, often unseen ways, is of particular interest.
• The therapist is present. The therapist endeavours to be a safe, steady human presence that is willing to ‘be-with’ the client moment to moment, whatever emerges. The therapist is genuine and congruent,² aware of their inner experience and communicating it honestly to the client. “Presence involves bringing the fullness of oneself to the interaction. Therapists must be willing to allow themselves to be touched and moved by the patient” (Jacobs, 1991, p. 4).
• The relationship works as a collaborative partnership. Relational therapy does not involve a client talking to a powerful, distanced therapist who gives information or makes interpretations; it is a constantly evolving, negotiated, co-created dialogical process to which both therapist and client contribute (Evans & Gilbert, 2005). Here relational therapists need to ask themselves regularly, ‘How am I contributing to our relationship? Is the way I am being facilitating or inhibiting the client’s awareness and contact?’

Working relationally means privileging the emergent, here-and-now intersubjective relationship between therapist and client (see figure 1.1), for this is where we flexibly attune to each client’s relational needs (DeYoung, 2003; Spinelli, 2015). It’s about opening to the other while being willing to give of self. The therapist needs to have the courage to stay in ‘the process’: to be emotionally present to intrapsychic and interpersonal dynamics and be aware of the particular sociocultural context,while being prepared to take some risks towards the co-creation of experience, understanding and knowledge. The challenge is to embody ways of ‘being’ and ‘being-with’ (as opposed to just ‘doing’) naturally and effortlessly, rather than be led by some intellectual principle. It’s about being present as a human being first; as a therapist second (Finlay & Evans, 2009).

Where the dialogue is fulfilled in its being, between partners who have turned to one another in truth…the world arises in a substantial way between men [sic] who have been seized in their depths and opened out by the dynamic of an elemental togetherness. The interhuman opens out what otherwise remains unopened. (Buber, 1965, p. 86)

Figure 1.1 The ‘between’

How we operationalise this relational dimension and bring it into therapy varies according to perspective and context (Paul & Charura, 2015). A key debate revolves around the extent to which we privilege t...

Table of contents

• Cover
• Title page
• Copyright
• Dedication
• Foreword
• Preface
• Acknowledgements
• 1 What is Relational Integrative Psychotherapy?
• Part I Being and Doing Processes
• Part II Theory Applied to Practice
• Postscript
• References
• Index
• EULA