What is relational therapy?
When you start therapy, you also start a relationship. And this relationship has the potential to be transformative. If you feel comfortable with your therapist, you may tell them things you have never told anyone before. This can undo the loneliness and shame that is at the core of many of our most difficult struggles. But what if you’re not comfortable with your therapist? Or not really comfortable with anyone? A relational style of therapy could help you to work through the barriers that prevent you from trusting your therapist enough to make the most of therapy. So what is relational therapy and why does it help in establishing this important sense of safety?
I think it would be helpful to start by looking at how relational therapy diverges from a long-standing norm of therapy.
The therapist as the “blank screen”
If I am beginning work with a client who has been in therapy before, I’ll usually ask what they did and did not like about the experience. Often what I hear is that the therapist was supportive, but too quiet or too passive and they wanted more. This supportive, quiet, passive stance is common in therapists and there’s a good reason for that. For most of us, our training emphasized that we should bring as little of our emotions, opinions, and biases into our sessions as possible. We do this in order to avoid distorting the conversation or making it about us.
The intention here is good, and the core of this idea is valuable. The emphasis should be on the client and, if we share our perspectives too loosely, we may inadvertently put pressure on our client to feel the same way. Or, we may offend them or put them off. This neutral approach goes back to the earliest days of therapy and Sigmund Freud’s assertion that the therapist must be a “blank screen” so the client can project all of their fantasies, anxieties, and thought distortions onto their therapist. If this happens, then the therapist has a real and undistorted sense of what the client is struggling with.
Attachment and emotional safety
The problem with the “blank screen” approach is that it emphasizes this risk of distortion over emotional safety in the relationship. Attachment theory has taught us that being with someone who feels emotionally distant actually feels similar to a threat to our safety. And when we feel unsafe, we go into fight-flight-freeze mode. This means our sympathetic nervous system may be activated and we may actually be unable to open up and be vulnerable, even if we want to. So the “blank screen” approach may actually run counter to the overall goal of therapy, which is for the client to feel safe discussing their most personal thoughts and feelings.
For people who have a history of complex or relational trauma, this may be particularly inhibiting. If you grew up with a parent or caregiver who was unpredictable, a slight shift in their mood could have been an actual issue of safety vs. danger for you as a child. As an adult, you may still be highly tuned into the little nonverbal signals that let you know if a person is safe or dangerous. In fact, this hypervigilance may be what brought you into therapy. But if you can’t get a gauge on whether your therapist is emotionally safe, your nervous system simply won’t let you trust this person.
So what is relational therapy?
With a relational therapy style, your therapist is taking this into account. They are centering the fact that therapy is also a relationship and that, just like any other relationship, trust cannot be assumed. It must be earned. Some of this trust may be built into the dynamic. A therapist is legally and ethically bound to keep your conversations confidential and most therapists chose this profession out of a genuine desire to help. But these conceptual components cannot be communicated to the autonomic nervous system, which is attuned to the moment-to-moment relational dynamics.
When using a relational style, your therapist will check in with you about this. Your therapist may ask you questions like:
“What is it like for you to be with me right now?”
“What are you feeling towards me as you share this?”
“Is there any part of you that’s not so sure about me?”
“What is your sense of me in this moment?”
At first, these questions can feel awkward. Most of us learn to hide away feelings of discomfort or distrust of others. So when your therapist asks these kinds of questions, it may feel risky to answer them honestly. Or it may feel socially taboo that someone is asking you this in the first place.
However, an honest answer can be a valuable opening to explore how trust issues are showing up in your relationship with your therapist. These issues could stem from something about your therapist. Perhaps they have said or done something that made you uncomfortable or wary. It could also stem from your own history with people whose identities are reflected in your therapist. For example, if your therapist is a cisgender man and you have had a lot of complicated relationships with cisgender men, it may be harder to trust your therapist because of those experiences. Or perhaps these issues could be a more generalized thing that you struggle with in all relationships.
Regardless, talking about it offers an opportunity for you and your therapist to explore what is happening between the two of you and what can be done to help you feel safer. It can also present an opportunity to explore any part of this dynamic that is historical for you and how it could be impacting other relationships that matter to you. Doing that could be a first step toward pulling down a wall that makes it difficult for you to feel truly close and connected to the people you love.
Intentional self-disclosure
As I mentioned earlier, there is a longstanding tradition of therapists holding back in sharing. And, in many ways, this is a good thing because it keeps the focus on you, the client. However, there are certain times in therapy where your therapist sharing what they are thinking or feeling could change a lonely moment into a transformative one.
Take for instance a moment in which you are feeling incredibly embarrassed or ashamed about a trauma that you experienced. Shame is a common response to trauma and often makes us feel that the trauma was our fault or that our own flaws or shortcomings explain why it happened. If the trauma is something like a sexual assault, this could have a big impact on your relationship to yourself, your body, and your sense of safety in the world.
If your therapist is using the “blank screen” approach, they may ask you probing questions aimed at helping you explore these thoughts and feelings. Though this may be insightful, you are essentially still alone with your experience. But what if your therapist chooses to disclose their feelings?
“As I hear about this experience that you had, I am feeling so sad that you had to go through that and also very angry at the person who did this to you. What is it like for you to hear the impact this is having on me?”
Any therapist is likely to have emotional responses in a moment like this, but a relational therapist may make their emotions explicit.
“Undoing aloneness”
A relational therapist takes an approach that allows them to share their own feelings and perceptions with you. This can help you to feel safer, in that you know what your therapist is actually thinking and feeling in your most vulnerable moments. They aren’t deflecting when you most need to know that they care. It also presents an opportunity for you to feel less alone with the experience as you witness a real emotional impact on someone who cares about you. One of the most painful aspects of trauma is that it leaves us feeling alone. The relational style of therapy called AEDP (which I am trained in) sees “undoing aloneness” as one of the most important tasks of the therapy experience.
There are many reasons that a relational style of therapy can be more impactful and transformative than other types of therapy. Most therapists know that the therapeutic relationship is the most important tool for healing, but not all therapists intentionally explore and explicitly discuss the relationship they are developing with their clients. If you have felt limited by emotional distance or the sense that you do not really know what your therapist is thinking or feeling, this is a normal response. If you feel this way and have experienced relational trauma, you may need to feel more security in your therapy relationship before you can open up. Relational therapy may help you to feel that essential sense of safety so you can truly start healing the parts of yourself that are most prone to hide and hold the most pain.
Read a blog about experiential therapy.
