The therapeutic alliance model

Please share this with anyone who you think can benefit from this post in your networks.

I do not know if I have shared this yet, I am working on a new model in therapy/counseling, though i prefer to use the phrase collaborative dialogues. There are many sides to any new work, and a good part of it comes from actual work with real human beings, understanding their stories and situations and helping them create change in their lives, by understanding their situations with greater clarity and hope. So even as I collaborate with many across time and space, I want to keep writing these posts so that everyone can read something of value from one story or another. We are all after all connected to one another and there is definitely something common in stories. Please bear in mind that most of my work lies in the domain of working with those given serious mental illness diagnosis. There are many psychologists who can deal with other issues, but my chosen domain is mental illness necessarily.

Any dialogue with a therapist or collaborator is done with many purposes. Often therapeutic dialogues are an adjunct to medical directives, and the role of the psychologist, therapist or counselor is to ensure compliance of the individual for psychiatric prescriptions. Is the work I am doing more of the same or is it any different? This blogpost is meant to answer this query, and to define what the aim of a therapeutic dialogue should be or what to expect from me, if you are working as part of such an alliance with me.

Even though human life seems like a complex puzzle at times, the complexity of the situation is often most for those who are caught in the situation and not for those who are outside of it and can see things with a wee bit more objectivity and distance. It occurs to me at this point that I have been talking to a lot of people lately who are or have been caught up in little or big acts of rebellion against situations in their homes. A few months ago I had done a little dissection of the process that creates rebels via this blog post. That still remains pertinent. Everyone must understand, as part of dissecting their own psychic turmoil, where the first seeds of that suffering were sowed, and what part of it came from the family directly. I am not holding the family entirely responsible, but definitely every family has contributed, though every person in the family would have contributed unequally, and some may have been also able to mitigate the damage caused by others.

So coming to the point of this post, there is a three pronged program that a therapeutic alliance ought to accomplish-

  1. Help the person understand their past, and get free of it in the present. I say this with a certain deliberation because often when people come to meet therapists as adults they are carrying the suffering and pain of their childhood traumas. Since no therapist can go back in the past now, the only thing we can do is to help everyone come to terms with it, in such a way that it has been dealt with and integrated in the psyche, without being able to cause any further damage. The best act is when people understand that they are no longer governed by their past and the past is gone with the past and it need not continue in the present– so with that we come to the next step.
  2. Help someone take better control of the present and steer the direction from a state of helplessness and dependence, on whatever that dependence be currently- medication, family, spouse, siblings, friends- to a state of greater and growing autonomy.
  3. Look at the future with a reasonable amount of courage and be able to start creating a life, which they can given their ability, intelligence, skill set and age-appropriate roles they could be playing. One of the key thoughts I have seen running in common about people is anxiety about the future and this is the one thing all collaborators must remember, because the future will take care of itself if we can deal with the present in a sensible way. So focus on taking control over whatever you can manage in the present- the point 2 above.

This is the attitude that I have with anyone when I am talking to them- understanding where they stand today, where they come from and which way they are headed. In integrating these three strands, if we can all do it together, you will understand that the whole act of the alliance becomes successful. Or else you can keep going to your therapist for the rest of your life. But that is not the sort of work I do, nor intend starting now.

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