What do we mean by ‘relational’?

Online Zoom CPD Weekend with Michael Soth

Online CPD Weekend 20 & 21 May 2023, in English with expert simultaneous translation into Greek

Organised by Dimitris Tzachanis:[email protected]?

For all booking and admin enquiries, please contact Dimitris.

The inspiration for this workshop (following several previous talks and study days on this topic) is based on my experience of teaching relationally-oriented cross-modality or multi-modality CPD groups of therapists, and my sense that there is a lot of diversity as well as confusion as to what different therapists mean when they call themselves ‘relational’.

Acknowledging the conflicted diversity of relationality

Unless we first acknowledge just how different (and partially contradictory) these different notions are, and come to some shared understanding at least of these differences and contradictions, we are likely talking at cross purposes, thus confusing ourselves and everybody else (other helping professions as well as clients).?

One obvious polarisation is between humanistic and psychodynamic notions of therapeutic relating, but even within these broad branches of the field there are significant qualitative distinctions and opposing views between different approaches and schools.

That there are in existence across the therapeutic field diverse, distinct and contradictory modalities of therapeutic relating is a point that was, of course, forcefully made originally by Petruska Clarkson in 1990[1], and I will be drawing and building on the foundations laid by her model.?

It’s the relationship that matters

Over the last 15 years or so, relational perspectives have had a significant impact across the field of psychotherapy. However, the wider its increasing influence has spread, the less clear it has become what we actually mean by ‘relational’. The default common denominator would be the recognition that in therapy it's the relationship between client and therapist that matters, and that the quality of that relationship is a significant indicator of outcome.

However, whilst there is quite a lot of agreement that the therapeutic relationship and its ‘quality’ matters, this apparent consensus breaks down at the first hurdle: there is no such level of agreement as to what actually constitutes ‘quality of relationship’. On the contrary: there is a tendency for the traditional approaches to define ‘therapeutic relating’ predominantly within their own frame of reference, taking their own paradigm of relating for granted.?

An apparent consensus only skin-deep

It is, therefore, not generally accepted - inspite of Clarkson’s widely known contribution - that 100 years of psychotherapy have given us a diversity of distinct notions as to what kind of relating is to be considered ‘therapeutic’. The least controversial common ground of ‘relationality’ is probably a negative distinction from classical one-person psychology and the supposed non-relationality of the ‘medical model’, but beyond that it is unclear what kind of ‘relational other’ the therapist is or should be.

Lavinia Gomez – in thinking about the paradigm clash between psychodynamic and humanistic traditions – tried to locate the essential difference between them not in their respective theories or techniques, but in their divergent conceptions of the therapist’s relational stance[2].

Does therapeutic relating mean - in Gomez’s terms - being ‘alongside’ the client as an?ally?or ‘opposite’?the client?as a relational ‘other’??

And then what?kind?of ‘other’: a positive, nurturing and reparative other or an authentic/dialogical other or a transferential other? And if we include the option of a transferential other, then that inevitably also involves negative transference and the other as a ‘bad object’. That in turn begs the question what role relating to and as the ‘bad object’ has in therapy and who relates to it how??

This is crucial, as the manifestations of the ‘bad object’ – in whatever way we conceive of that – within the consulting room constitute a ‘negative’ enactment (or re-enactment) of the client’s wounding??– in whatever way we conceive of that. Embracing the presence of the?‘bad object’ in the consulting room and giving it any validity at all?immediately contradicts the public preconceptions of therapy as only benign, helpful, supportive and healing.

The apparent consensus across the field that being ‘relational’ is a?good?thing is only skin-deep as long as we skate across the surface of these profound contradictions (which the field has fought over?long and bitterly?over the last century, and presumably that wasn’t for nothing). It could be argued that such a premature?skin-deep?consensus can actually become counter-productive and dangerous to the movement of relationality as well as to our practice, because colleagues, clients and the general public have a valid and inescapable sense that we are?not?all talking about the same thing at all when we declare ourselves as ‘relational’.

A complex, coherent pluralistic whole or a fragmented eclectic heap?

Whether we think of it in terms of traditional therapeutic approaches or in terms of a diversity of relational modalities, it could be argued that the multitude of perspectives in psychotherapy generates a pluralism and diversity which is a?strength?of the field. Pluralism in society – like biodiversity in ecology is a?good?thing – it makes any system more robust and adaptable – it’s better than a normative and uniform mono-culture, isn’t it?

But?is?the diversity in the therapeutic field a strength, and is our profession perceived as that??

Or are we perceived as fragmented, divided, incoherent, disjointed, with each perspective splitting hairs and absolutising its own preciousness, invalidating other approaches and competing with them in what looks from the outside like tribal warfare?

Do we together make a robust, collaborative, coherent field, where the conflicts and diversity create a synergy (precisely like a biodiverse eco-system)? Or are we perceived as a mottled collection of self-serving, self-replicating therapeutic sub-cultures that scour their niche of the market in a cult-like fashion? Are we perceived as collaborating in the interests of clients, giving them ‘patient choice’ and what they truly need, or are we competing in the internet bazaar of infinite, irrelevant whimsical preferences?

I think these questions apply to the field of therapy as a whole, and they apply to the recently fashionable movement of relationality.

The bright new world of ‘two-person psychology’?

It could be argued that we?do?have as a consensus across the relational movement, and what does hold us together is a common ‘enemy’: the classical ‘one-person psychology’ of the ‘medical model’ which we have supposedly outgrown and transcended.

These terms were popularised by Martha Stark’s seminal 1999 book “Modes of Therapeutic Action”, in which she evolved and built upon some suggestions and distinctions initially proposed by Stephen Mitchell.

Her book was addressed mainly to a psychoanalytic audience, and there can be little doubt that the developments she describes towards modern ‘two-person psychology’, intersubjectivity and relational psychoanalysis constitute a precious paradigm shift, which builds bridges across the same psychodynamic-humanistic divide that Gomez is trying to address[3].

Relational stances, modalities and kinds of therapeutic relatedness = relational spaces

Although they use slightly different terms and languages, Clarkson, Gomez and Stark are all conceiving of the essential differences between the diverse therapeutic traditions?not?in terms conceptual models, but in terms of the underlying relational space which gets co-created between client and therapist. The paradigm shift towards relationality underpins all three contributions, as they focus on the therapist’s relational stance (rather than theory and technique), i.e. the therapist’s whole personal-professional?presence?and?being?rather than what’s going on in their strategic expert head through the definition of their helpful role and what they therefore?think?they are?doing.?

All three -?Clarkson, Gomez and Stark -?recognise distinct and diverse therapeutic spaces, and all three of them credit each kind of relatedness - within the whole spectrum of relationalities they define - as having partial validity. Therefore, all three of them manifest an integrative relational intention which embraces the whole spectrum of kinds of relatedness, and can provide a basis for a more coherent relational movement, and a more coherent therapeutic profession.

Such possible coherence does not equate with bland difference-denying uniformity or the loss of plurality. But coherence?does?require that we become aware of, acknowledge and engage the inherent and inherited conflicts and contradictions, which often manifest as unproductive and painful polarisations between us.

The aim of this workshop: integrating Gomez, Stark, Clarkson

Many of you know that over the years I have tried to integrate different ideas regarding ‘relationality’, i.e. the actual diversity of therapist’s relational stances which we find across the traditions, particularly Petruska Clarkson’s relational modalities, but also contributions from Lavinia Gomez as well as Martha Stark.?

I will propose that the different ideas of these three elders nicely complement each other, compensating for the deficiencies and flaws of each of these three models just by itself. The more comprehensive version that I have been developing by combining all three of them I have called the ‘Diamond Model’ of relational modalities.

The?‘Diamond Model’ of relational modalities

The idea of this workshop is that we will experiment with this model and explore its helpfulness when applied to practice. That means we will need to build up a shared language throughout the day, familiarising ourselves with the notions and distinctions offered by Gomez, Stark and Clarkson, before we combine and integrate them. This will also imply an overview regarding the history as well as the diversity of different meanings of the term ‘relational’. Establishing such an overview, which includes an appreciation of the diversity, differences and contradictions, is a prerequisite before we can come to any kind of integration.

In order for us to be efficient and able to come towards an integrative perspective within the one day, it will be most helpful if everybody has a basic understanding of the traditional terms and concepts. Ideally I will be wanting to juggle the differences and contradictions between them rather than clarifying the terms and models themselves.

Previous Talks/Workshops

3 hour talk with Michael (20 October 2016) on Youtube???2:43:37 What Do We Mean By Relational?

[1]??????in her seminal paper:?"A Multiplicity of Psychotherapeutic Relationships"?which became the foundation of her later book Clarkson, P. (1995)?The Therapeutic Relationship. The?first chapter of that book?provides a good summary of the five modalities of therapeutic relating she distinguishes.

[2]???????????Gomez, Lavinia (2004)?“Humanistic or psychodynamic - what is the difference and do we have to make a choice ?”?in: Self & Society Vol. 31 No.6 Feb/Mar 2004, p. 5 - 19

[3]??????as the humanistic tradition had a focus on the psychology of?both?people involved in the therapeutic relationship as one of its axioms from the beginning (Buber’s ‘I-Thou’)