● Being in a relationship with others is a basic goal of development. The deepening capacity for relationship and relational competence is a primary developmental goal. Other aspects of self, such as creativity, autonomy, and self- assertion, emerge within the context of relationship, without needing to disconnect or sacrifice the relationship for self- development. ● This component of the model directly addresses the need for and the power of the therapeutic relationship in healing the relational wounds of trauma. The isolation of the original wounding is challenged by the connecting relationship. The old psychotherapy model of “tabula rasa” or “blank slate” is not appropriate for work with trauma survivors who need the warmth of human interactivity. ● Empathy is a crucial feature. As examined by Surrey (1991) and Jordan (1991), there is a focus on mutuality and mutual empathy. Stiver (1991) describes mutuality in the therapeutic relationship as related to emotional authenticity. Empathic attunement includes balancing the affective and the cognitive components of a situation in order to accurately identify with another’s feeling state.This component challenges a victim’s trauma lens of abuse by balancing the tendency to polarize every relationship into victim, perpetrator, and bystander with empathic engagement by the clinician that includes all parts of the client’s self, thus paving the way for the client to develop self-empathy. ● The parent–child relationship is the paradigm or model for other relationships. The strengths and weaknesses of this primary relationship often greatly influence the capacity or ability to engage in other relationships in life. Mutuality can occur as the parent and child mirror each other and give to each other. When the original parent–child relationship has been abusive or neglectful, the reparenting aspect of the therapeutic relationship can provide a balm and an alternative model for healthy caregiver relationships. ● The basic developmental task is relationship differentiation. Differentiation of self takes place within—not after, instead of, or outside of—the context of the relationship itself. This construct allows the clinician to challenge the errors of all-or-nothing thinking and the tendency to polarize and “catastrophize,” both of which often occur in survivors’ relationships, by making a place for the differentiation of self to take place within the relationship. The survivor can experience being validated for their whole self as well as for all of their differentiated parts of self, in the context of the healing relationship. ● Relational authenticity is valued. Surrey (1991) defines relational authenticity as the “ongoing challenge to feel emotionally ‘real,’ connected, vital, clear, and purposeful in relationship” (p. 60). It includes risk, conflict, and expression of the full range of affect. This construct allows the client to practice being fully themselves and real in the therapeutic relationship, rather than being ruled by fear, anger, or powerlessness in relation to someone who holds more power than they do. By definition, the clinician holds the power in the therapeutic relationship. Case Example Molly came into a session during her third year of treatment and said to her therapist, “I am really mad at you. Do you remember when I brought my mother to therapy with me two years ago? I think that you really let her off the hook that time. I wanted you to hold her accountable for abandoning us to our father. I am realizing now how much she was also to blame for all we have suffered.” The clinicIan’s response is crucial here. Remaining in connection and responding with authenticity, rather than defensively, is important.
The clinician’s relationship with the client is also subject to the same potential for distortion; therefore, the clinician must use their inherent power responsibly, and the relationship with the client must be open for discussion and clarification. The following example demonstrates how the client’s nonprotecting bystander worries can be triggered and allayed by the clinician. Case Example George said, “I was a little worried about seeing you when your phone message said that you might not be available to call me back right away and to call back again if I hadn’t heard from you in a day or two. But the fact that you were able to talk about it and didn’t get defensive and that you clarified that it didn’t include emergencies because you always have someone on call when you are away helped a lot. To know that I can tell you if I was upset about something you said or did was really crucial for me.” Following trauma, the resulting damage to worldview, sense of self, and relationships with others can be traced back to the meaning the survivor has made out of the traumatic events. The compromised relationships can be between self and others, between different self parts, between self and the world, or between self and God or a higher power. Interpersonal relationships are often fraught with difficulty for survivors of trauma. Thus, healing must occur in the context of a relationship or, better yet, in the context of multiple positive relationships. Relationships become the core of treatment, and all therapeutic approaches or interventions must take place within the context of a healing therapeutic relationship. The therapeutic relationship can become tenuous for survivors of trauma, as clients are asked by the clinician to extend trust and share intimate details of their lives, following a history of betrayals, breaches of trust, and abuse or neglect by other caregivers in their past. It is no wonder that the transference is often traumatic in nature. James Chu (2011) refers to the roller coaster of therapeutic engagement and the dance the client engages in between mistrust and trust, anger and empathy, and disengagement and connection that is often part of the early stages of treatment. Conscious use of self is crucial for the clinician. The key to all good trauma treatment is relational attunement, empathy, attachment, and the clinician’s validation of the client’s needs and experiences. Empathy and attunement, which require tuning in and being “in sync” emotionally with another person (an aspect of empathy), are core therapeutic factors and serve to validate clients’ needs. Healing takes place when “we can return to the pain of the past, and find that this time, we are no longer alone” (Jordan, 1991, p. 287). Being truly seen and heard by a nonjudgmental and caring person begins to rework and re- establish some of the earlier relational ruptures that occurred in the face and in the wake of trauma. Self-in-Relation Theory Starting in 1976 with the work of Jean Baker Miller, a collaboration of scholars at the Stone Center at Wellesley College, originally directed by Miller, developed an alternative model of psychological development called self-in-relation theory. At first, it was formulated to understand and differentiate women’s psychological development from that of men, in contrast to Erik Erikson’s model of psychological development. Subsequently, it was expanded to include a relational therapeutic treatment approach that was applicable to both men and women. From this theory, a model for group development, which informs practitioners who work with vulnerable and traumatized populations, was also developed (Schiller, 1995; Schiller & Zimmer, 2005). This theoretical perspective is useful when engaging in treatment with trauma survivors. Surrey (1991) describes the five main components of this model.
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Book Code: PYFL4024
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