Tuesday, 5 November 2013

The tensions and contradictions between authentic and reparative modalities of therapeutic relating

I am currently writing a chapter for a book, which addresses some questions I frequently hear, regarding the relational modalities:

The crucial inspiration for authentic relating, however - pre-dating the explicit formulation of  intersubjectivity by several decades - came from Martin Buber’s dialogic philosophy (1947), which had a fundamental impact on Rogers, Perls, and the humanistic movement, captured in the phrase ‘I-Thou’ relating.
Already during the 1960’s and 1970’s humanistic writers had begun to question the psychoanalytic tendency to absolutize the transference as the be-all and end-all of the therapeutic relationship. Many of them had come through psychoanalysis and understood that the transference was helpful in understanding the vicissitudes of the therapeutic working alliance. But they also recognized that much of psychoanalysis had ossified into a one-sided and fixed relational stance which more often than not  was liable to undermine and destroy the working alliance, by a punitive attitude against ‘acting-out’ and the analyst’s habit of reducing everything that happens between therapist and client to transference.
The humanistic movement was inspired by an intuition – years later to be articulated by Petruska Clarkson (1994) - that the therapeutic space is and needs to be relationally complex, with the therapist capable of flexibility and fluidity between all the modalities of therapeutic relatedness, rather than dogmatically as fixed in their relational position as the client is in their characterological position.

In pursuit of the unfolding of the client’s full potential, humanistic therapists were willing to experiment (as analysts as Ferenczi, Reich, Sullivan and others had done) and found that both authentic and reparative modalities held therapeutic possibilities which psychoanalysis was categorically ruling out and excluding. There was some understanding that many psychoanalytic ‘rules’ instituted by Freud had grown out of his reaction against his traumatic experiences with the intensity of the erotic transference in his early practice, and that these principles and guidelines of practice needed revising, especially in the light of the new cultural context of sexual liberation, then 60 years on from Freud.

However, in its evolving anti-reaction against the objectifying, patriarchal and power-over paradigm of classical psychoanalysis, humanistic therapists often tended to swing from one extreme into the opposite. With the precious discovery of anti-hierarchical modes of relating often turning into an egalitarian ideology, rather than habitually enacting a fundamental relational inequality as psychoanalysis had done, humanistic therapists now started habitually avoiding any trace of inequality. Throughout the humanistic approaches, this resulted in a relational stance designed to systematically side-step and short-circuit the intensity of the transference – one reason why Body Psychotherapy has been criticized for neglecting the relational dimension of therapy.

Whilst often based on psychoanalysis merely re-stating the rigidity of its classical paradigm as well as prejudice, its critique of relational obliviousness in the humanistic field is substantially valid: by conflating reparative and authentic modes of relating into a confused blend, the subculture of humanistic psychotherapy has long managed to avoid an inconvenient feature of reparative relating: it is by definition inherently and necessarily unequal, and in its extreme is positively infantilizing. By wrapping the reparative stance within a philosophy of authentic, dialogical relating (which is by definition inherently and necessarily equal), the unpalatable aspects of reparative relating can be denied and rationalized. Repair of the client’s maturational deficiencies and provision of the developmentally needed responses – as valid and necessary as they are to the fullness of the therapeutic endeavour – inevitably involves the client experiencing – from within their subjective experience of the deficiency (i.e. from within the regressed state at the root of the deficiency) – a sense of need and inequality, even helplessness and feeling at the mercy of the other.

But even worse than that: contrary to the humanistic principles of I-Thou relating, a reparative stance inevitably involves a perception, not to say: a diagnosis of the wound and the deficiency. The reparative mode is inseparable from a sense of objectification – with a benign, motherly, nurturing attitude, but objectification nonetheless. The developmental deficiency – or more precisely: the client’s unawareness and defence against the wounding inherent in the deficiency - interferes with the client’s capacity for mutual intersubjective recognition: reparative relating cannot get around some kind of ‘medical model’ implications. There is a fundamental tension and opposition between reparative and authentic modalities of relating – a tension which can be navigated and worked with, but it should not be denied and collapsed. One of the shadow aspects of the humanistic tradition, therefore, are hidden and denied ‘medical model’ assumptions which pervade both theory and practice (Soth 2005, 2008).

Humanistic therapists and writers have developed a host of ways to fudge this issue: by re-formulating the repair not as an unequal interpersonal dynamic, but as the client’s self-healing process; by claiming – quite rightly – that the equality of authentic relating is reparative of the wounds inflicted by a history of unequal relating.
But none of these manoeuvres get around the conundrum: the experience of developmental repair implies the experience of the wounding, in a context of inequality; without the client actually feeling the deficiency which we are supposedly repairing, and therefore feeling unequal, we are colluding with an avoidance of the wound. This is the inescapable logic of the Kleinian opposition to any kind of gratification of the client’s needs and demands, any kind of fudging of the wound and the inherent helplessness, as well as frustration, anguish, envy and fury.

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