Issue 9/2016 summary

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Issue 9/2016 summary

Elena Khizhnyak (Russia). Mutual dependence in therapeutic relations

It is relatively rare that existential literature describes the phenomenon of mutual dependence in therapeutic relations.

Based on one of the principles of existential therapy, we talk about mutually dependent human nature. We always are in relations with other people, we emerge through these relations, and simultaneously we feel uncertainty because of it, leading to anxiety, and we try to mitigate its pressure by relying on stereotypes in daily life.

In therapeutic relations, mutual dependence is a lived phenomenon. The most significant is, according to Laing, mutual experiencing, which expresses what happens between two people in therapy. This dependence can be called mutual, because the therapist as if resonates with the clients, which allows him to be co-present with him.

When they enter therapy, many clients complain about loneliness, the emptiness of their life and the absence of satisfying relations with other people. The clients hope and expect that help will come from the therapist.

It often happens in the therapeutic practice that the therapist assumes the positions of a knowledgeable and wise teacher, expert or parent, who understands about the client and his life much more than the client himself. A client can very easily become dependent in such a way as to pass responsibility for his life to the knowledgeable specialist. But also with such interaction a therapist can create co-dependent relations, satisfying his secret and not always conscious needs for power and significance to others.

If we provisionally divide the process of therapy into three stages, as suggested by E. Spinelli, our interaction with the client at the first stage is built in such a way as to create our common ‘therapeutic world’. Daniel Stern called the process ‘mutual progress’. ‘It is a wonderful process, because its essence is that the client says something, and the therapist does not know what they will be doing or saying next until the client says something… and they create together the direction in which they will be moving’ (Stern, 2008). Gradually, the ‘therapeutic world’, the interaction between the therapist and the client, shows those ways of the client’s being that he builds in the ‘lived world’.

At the second stage, all difficulties, all tension and uncertainty appear in the therapeutic space. The client realises that the therapist is an Other, he faces the need to be next to the therapist’s otherness. By realising the differences of our Worlds, we seem to be drawing a border between them. In our mutual challenge, we can experience our autonomy, distinctiveness from each other, which is very important for therapeutic relations.

When ‘much more life’ enters the therapeutic world, when, together with the client, we can more openly explore both the therapeutic and the lived world, our mutual dependence becomes a position of cooperation, co-creativity and mutual respect. In these mutually dependent relations, the client can still have enough space for satisfying his needs, achieving his goals and developing.

In mature relations with a client, we can simultaneously come closer to each other, feeling attachment, and grow more distant, without losing personal identity, without suffering from repudiation, the feeling of uselessness, abandonment and inability to be without an important Other.

When at the final stage of the therapy a client can be in already sufficiently mature relations with the therapist, he gradually transfers the experience gained in the therapeutic space into his world. By feeling connection, mutuality and at the same time distinctiveness from the therapist, the client completes his uneasy way in therapy.

Thus, speaking about the peculiarities of mutual dependence as a dynamic process, it is interesting to note that, in therapeutic relations, there are created such ways of connection between a therapist and a client that are similar in their intersubjective depth to those existing in dyads – in a couple, between a mother and a child, etc. The dynamics for the development of mutual dependence is similar to a person’s ontological development – from dependence in relations to autonomy and to mutual dependence, to holding tension between the poles of existence together.

Thinking about therapeutic relations, it is important to acknowledge that a therapist sometimes finds it hard to remain in the state of indeterminacy and unpredictability throughout the entire process of therapy with a client, who builds mutual relations. How to react to the ways of being offered by the client? To what extent is a therapist ready to reflex his experience of being and doing something with the client and for the client? Will not the therapist develop hidden goals and tasks in the therapeutic interaction? Is not the therapist growing dependent on the client and the process of therapy? How can this dependency be manifested?

A realistic attitude to the feelings and personal mindsets that are in us helps to take a different look at ourselves and at the relations that are created in therapy.

The tendency of a therapist to dominate and lead, to impose one’s notions and value system is relatively common in therapy. A therapist’s leadership in this position leads to pressure and can even be experienced as violence by the customer. Frequently, a therapist is literally ‘dragging’ him (the client) towards the ‘right’ decision. In this situation, the client either feels growing resistance and completely loses trust in the therapist or develops dependence on the therapist and has the feeling of one’s powerlessness. Then the client puts on the shoulders of the ‘omnipotent’ and ‘omniscient’ specialist all responsibility for solving the problem.

There is yet another danger for the therapist, to create negative relations with a client. This hidden need of the therapist ‘to live through his clients those aspects of his life that he does not experience or cannot experience himself’ (Jacobi, 2007). In this case, therapy can prove for the therapist to be substitute for his personal life. Of course, if clients become too necessary for a therapist to maintain ‘zest to life’, then instead of real relations, an unhealthy case of co-dependence develops.

Yet another one important aspect of a therapist’s dependence is paid relations between a therapist and a client, where the therapist is financially dependent on the client. A client can terminate therapy, suddenly break it, ‘taking away’ with him the money on which the therapist relied. As a result, if the therapist is feeding dependency, a potential conflict of interests arises. One of numerous aspects of this research may be the therapist’s wish to have many clients in order to work freely and feel certain confidence in himself. One impediment to this wish is the issue of payment. If payment for the therapy is too small or even non-existent, then in practice it can mean that the therapist becomes to the client a kind mummy or her likeness, and he is entitled to gratitude for it. On the other hand, by raising the fees to much, the therapist becomes dependent on the client’s unrealistically high expectations that at every therapeutic appointment he is bound to do for the client a ‘little miracle’ of mastery and professionalism.

Speaking about a therapist’s dependency, it is very important to realise it, to understand it and to be open to it. Then it gives more freedom to be real in therapeutic relations, to be interacting with the client and building mutually dependent relations.

In order to find where the therapist and the client are close to each other, it is very important for a therapist to realise and understand his ways of connecting with other people. It is necessary to avoid recreating co-dependent relations with a client, whereby a therapist is satisfying his own needs for power, influence, success, love, ‘saving’, financial well-being, etc.

A therapist who takes a ‘balanced’ position can explore with the client who is creating dependent relations in the therapeutic space what and how the client is creating. Finding this way between them enables the client to see how he creates dependent relations with other people.

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