Therapist Self-as-Context and the Curative Relationship

J Contemp Psychother (2013) 43:159167 DOI 10.1007/s10879-012-9230-8

ORIGINAL PAPER

Therapist Self-as-Context and the Curative Relationship

Luc Vandenberghe Jocelaine Martins da Silveira

Published online: 10 January 2013 Springer Science+Business Media New York 2013

Abstract This article discusses how the way the therapist relates to his or her personal responses to client material during the session contributes to making the relationship with the client an effective tool for treatment. Ideas from third wave behavior therapy are used to describe aspects of therapist involvement in the relationship and modes of therapist awareness of inner responses. In two vignettes, negative client reactions to an intervention bring problematic therapist material to the fore. Both cases highlight how the stories the therapists spun about themselves as professionals and persons could easily have limited their effectiveness in responding to the material. The vignettes also illustrate how clinicians can overcome personal meanings and judgments to access a more productive mode of interacting with the feelings a critical incident in the relationship evokes in them. It is argued that observing their own content from a psychological distance makes it possible for clinicians to use their feelings without getting caught up in them. These same feelings may then help the therapist perceive how the incident relates to the clients daily life problems. The therapists engagement in a sense of self-as-context is described as a therapeutic stance that provides the psychological distance needed to help overcome alliance ruptures and other potential gridlocks and which may transform the therapists inner response to client content into a tool for addressing important client issues.

Keywords FAP ACT Mindfulness Self

Third wave behavior therapy

This article is about mindfulness in the therapistclient relationship. The notions that will be used are drawn from a tendency in clinical thought that goes by the name of third-wave behavior therapy. This diverse group of treatments is heir to rst-wave behavior therapy, which introduced classical techniques like graded exposure, and second-wave cognitive behavior therapies that focus on modifying cognitive structures and content. The third wave added a stronger experiential approach and a more explicit functional contextual point of view (Hayes 2004; Hayes et al. 2011). Technical terms will be kept to a minimum to make the paper readable for therapists with existential/humanistic (e.g. Rogers 1957),...