Reparative Relationship

The next form is the reparative/developmentally needed relationship in Clarkson’s Framework. When the client’s original parenting was not appropriate, e.g. overprotective or abusive, as a result the client can be in distress. The counsellor should be willing to demonstrate what the client’s fantasy needs, e.g. a parent. 

By the end of therapy the client will internalise this emotional regulation by overriding the old harmful or damaging ways of relating to self. The therapist can provide the nurturing, praise and affirmation the client may have never had.

 

 

 

 

 

According to Clarkson this type of relationship is “an intentional provision by the therapist of a corrective, reparative or replenishing relationship or action where the original parenting was deficient, abusive or overprotective.” To provide a reparative relationship it is beneficial to know what the injury, or trauma was or what the developmental deficiency was. The arrested development is the point where the client  has some stuckness. After establishing the working alliance and potentially working through transference the therapist is able to offer and show a different kind of relationship, that of a beneficent parental figure, showing support, encouragement and unconditional positive regard. The counsellor should be aware of their own upbringing and have worked through their own issues in order to provide an unbiased, corrective relationship and to be able to fully focus on the client’s agenda.

Through the reparative/developmentally needed relationship the counsellor can facilitate client’s exploration of their patterns of behaviour, working through that together, helping them form new patterns and then carrying on with those new healthier behaviour. Naturally, learning new patterns to embed them into the client’s life can be a lengthy process. By providing a safe therapeutic space for this work to happen, using the person centred approach and the psychodynamic model integratively, clients can make beneficial changes. This way they can internalise the counsellor and develop an inner therapist  can have a huge, long term impact on their lives.

Clients might regress to a previous developmental stage in therapy. Clarkson quoted Guntrip: “regression is a flight backwards in the search of security and a chance of a new start.” What the client needed back then but was missing from the parenting (developmental deficit) can be provided by the counsellor in the here and now. The counsellor should consider the nature, severity and duration of the deficit which has led to the deformation, deprivation or distortion.

This theory can be linked to Erikson’s psychosocial developmental stages. It is important  to have a thorough knowledge of those stages in order to enable counsellors to identify the stages and the deficit related to that specific stage. 

According to Clarkson this reparative relationship  can happen in a group therapy setting too, where clients can re-experience an alternative family dynamic.

Bibliography:

 

Petruska Clarkson, The Therapeutic Relationship, Wiley, 2003

Transference/Countertransference 2.

According to Clarkson the second form of relationship is the transference/ countertransference, which can be linked to psychodynamic theory. Transference may occur in every relationship, not just in the relationship between the counsellor and the client. 

 

 

 

Transference is the client’s emotional response to the counsellor, it’s a process of directing feelings, attitudes and conflicts to the person one has a relationship with in the present. Child-like patterns of relating to significant others are repeated by the client. This operates at unconscious levels. Clients have a tendency to create a repeated replay of situations from the past with significant others, they seem to fit all subsequent relationships into these early relationship patterns. This phenomenon is called repetition compulsion. This repetition provides an opportunity for the counsellor to study transference at close range. By highlighting transference reactions and bringing these outdated or unrealistic responses into consciousness the counsellor can help the client to recognize the “as if” quality of the transference by linking it to a past experience. (“You’re reacting to me as if I were…) The counsellor can help by not repeating the same reaction which the client experienced in the past. The strengths of those negative feelings can diminish by being able to express them in a safe relationship for as long as it is needed. Gaining insight by bringing these feelings into consciousness gives a sense of control over them. However, changing deeply internalised attitudes can be a lengthy process. Many factors can cause transference feelings such as the counsellor’s voice, accent, physical characteristics or behaviour.

Transference can be positive or negative. The client may perceive the counsellor as helpful and understanding, this way the client can relive the parent-child relationship he/she might have never had. (like a reparenting process) Other positive feelings transferred can be: loving, admiration or even idealising.

 On the other hand, the client can transfer negative feelings onto the counsellor, such as reluctance, distrust or suspicion. It can also be a valuable opportunity for the counsellor to work with this obstructive transference by not adapting the role the client casts on him/her but by exploring the underlying issues instead. Attending to transference appropriately is crucial because it’s like a mirror in which the client’s past is reflected, it provides information about the emotional problems the client is experiencing. It can help to gain a deeper understanding of the problem.

The Triangle of Insight can be a useful tool to explore the client’s transferential experiences. It’s a psychodynamic concept, which was developed by Karl Menninger. According to this concept, how the client perceives the relationship with the counsellor in the here and now (“In Here”) is affected by the client’s earlier relationships with significant others from the past. (“Back Then”) The client’s current or recent past relationships with others are also affected. (“Out There”) These three aspects are interrelated. The counsellor can help the client to make connections between the different aspects by working with transference and gain insight of repetitive patterns.

Counsellors can also have inappropriate strong feelings that are evoked by the clients. Some of these might be evoked by the actual relationship with the client, others might belong to the counsellor’s earlier experiences with others, unresolved issues or own difficulties; and can distort view. Petruska described it as “unfinished business from the past interfering with our here and now relationship”. In other words: The experience of distortion of the working alliance by the wishes, fears and experiences from the past transferred onto the therapeutic relationship. However, it can be very challenging to differentiate between the two. If the counsellor can identify counter-transferential feelings he/she should contain them and not act on them.    

Supervision has a crucial role in working through these unresolved issues or blind spots and also separating the client’s needs from the counsellor’s own needs. The counsellor’s self-awareness has great importance. Counter-transferential feelings or reactions include: inability to confront the client, being over-protective, envious, sexual attraction towards the client etc. 

A kind of counter-transference occurs when the counsellor overidentifies with the client’s problem, for example one can get angry with the perpetrator when counselling a victim of sexual abuse, this is called vicarious identification. Clients can also project unacceptable aspects of self or feelings that can’t be expressed. This way the counsellor feels these as a recipient, this concept is called projective identification. The counsellor might experience extreme tiredness or think about the client outside sessions. Attending to counter-transference appropriately is important because this way we can provide autonomy to the client, keep the focus on the client’s agenda and also put our own agenda aside.

By working through transference the next level can be reached: the I-thou relationship when the transference is dissolved and the client sees the therapist as a genuine, congruent person. (not distorted)

Bibliography:

Petruska Clarkson, The Therapeutic Relationship, Wiley, 2003