Join Carolyn as she talks about how important the relationship between therapist and client is, and what factors go into making a good one.
Transcript
AS: Welcome to our podcast, Conversations with Carolyn. I’m here with Carolyn Spring.
CS: Hi there.
AS: Today we’re going to talk about the importance of the therapeutic relationship. It’s something that most people, like me, don’t really know much about. I suppose I have a few preconceptions about it but if I’m honest I don’t really understand why it’s so powerful. Can you explain?
CS: It is a strange thing, isn’t it? Why sitting with someone for an hour or so every week can completely change your life. It doesn’t seem enough, does it? And you’re right that it comes with a number of preconceptions. Before I started therapy, I had no idea what it is was all about either. I guess I thought that it was a supportive chat, a bit motivational, a bit of ‘ra ra’ and maybe pointing out where you’re going wrong, giving you a bit of advice, and then you would just be ‘fixed’. To be honest, a drugs cure seemed much more attractive. Because while I thought that I was mentally ill, I guess I thought that I would need a drug to fix me. Because after all, that’s our paradigm from physical health – if you’ve got bronchitis, you might need an antibiotic. If you’ve got cancer, you might need chemotherapy. So, I didn’t really understand how I could stop being ‘mentally ill’ without drugs.
AS: But then you began to reframe it as trauma, not mental illness?
CS: That’s right, but still the whole therapy thing didn’t make a lot of sense to me. I suppose I thought that if I just talked about what happened to me, that I’d feel better – I guess I had absorbed some Freudian concepts about repression, and so what I needed, I thought, was catharsis, although I wouldn’t have put it in those terms. And I needed it to stop being a secret. I certainly didn’t understand about processing and metabolising traumatic material or learning to feel safe in your body again (what’s technically called neuroception). I didn’t understand that it would be about retraining the brain, or anything like that. And I didn’t see that the therapeutic relationship is central to that.
AS: So, you wouldn’t agree with therapy being delivered by artificial intelligence then?
CS: Ha! It’s a funny idea, isn’t it?! I think there are some aspects of the recovery journey that can be delivered electronically if you like – for example, the psychoeducational aspects. Because there’s a lot of skills that we just need explaining to us, like learning a language. But even then, it’s much more real when that comes from another human being, when it’s rooted in real life, rather than being disembodied. I think left brain stuff of facts and information is so much more ‘learnable’ when it’s delivered in the context of the right brain relationship. So, delivering psychoeducation entirely by computer has its limits. And the really fundamental work of recovering from trauma comes, I believe, from this transformative relationship with another human being.
AS: How is it transformative? What’s it all about?
CS: I think the simplest way of understanding it is that we have experienced a wound – what we might call relational trauma. It’s been perpetrated or caused by another human being. And so we need to have a reparative experience, an opposite experience, where instead of hurt and harm and abuse, we experience care and compassion and empathy. That then has the potential to change the way we view other people, ourselves, and the nature of the world. It’s very powerful.
But it’s more than that too. It’s a lot about our brains developing and making connections through right-brain to right-brain communication, through mirror neurons, in exactly the same way that a baby’s brain grows in relation to its mother or other attachment figure. It’s not with words. It’s not cognitive
