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The intimate bond and therapy success

As a psychiatrist and psychotherapist for over thirty years, I am often asked why psychotherapy succeeds or fails.  I am reminded of a story told by one of my supervisors during my training. 

This grissled veteran recounted for us wet-behind-the-ears, budding psychotherapists how he had successfully treated a very troubled young man over a period of a few years.  When the therapy was ending, the therapist asked the young man what he felt was the most helpful aspect of the therapy.  He wondered if it was some key insight he had shared with the patient, guidance he had provided, or something else of that sort.  Somewhat to the therapist’s surprise, the patient responded, “You have kind eyes.”     
 
We mental health professionals are privileged to practice at a time when there are so many treatment options available to us to use to help our patients.  We can perform various types of dynamic psychotherapy, interpersonal psychotherapy, cognitive-behavioral psychotherapy, mindfulness, EMDR, and a vast array of other therapeutic techniques, including the use of psychotropic medication. 

But we’ve come to realize that what really drives the success of any therapeutic encounter is establishing a solid, empathic connection with out patient.  It involves being able to understand at a profound level the psychological and cognitive experience our patient has found the courage to share with us from his own personal perspective, free from our own assumptions or projections.  It involves our ability to put aside our preconceptions and relate to our patients pain based on her experience of that pain.  It involves our ability, once this empathic connection is established, to relate not only with understanding but also with compassion. 

It is this fundamental, very human experience that sets the wheels of healing in motion. 

Whether this type of connection becomes established or not depends, to a significant extent, on the skill of the psychotherapist, and the willingness of the patient to form this intimate bond.  Beyond that , there are definite factors, though often obscure and hard to identify, that are unique to how any two given people relate to each other...a “chemistry” if you will, that will determine whether this empathic connection ultimately occurs. Can we create this chemstry?  Even outstanding psychotherapists will often be unable to forge this type of connection with a patient, because they can't make it happen alone.  So, we continue to look for ways to help our future patients find ways to bond with us too.

Therapeutic success depends on it.

- Steven Field, M.D.

Posted by: AdminMarch 1st, 2015 Share