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Relational Therapy
Introduction
According to the hypostatic view of personality, there are four main things
that people do: they think, act, feel, and express their feelings. Changing the
relationships between these four dimensions of doing - both within the person
and in her relationships - is the scope of relational therapy (relatherapy),
just a part of a broader approach to psychotherapy.
Well-adjusted people act what they think, and express what they feel. These
are called direct intrapersonal relations. Also, in a relationship, they think
about others' acts, and feel about what others express. These are called
direct interpersonal relations.
Unadjusted people act what they feel, instead of what they think, or express
what they think, instead of what they feel. These are called crossed
intrapersonal relations. In a relationship, they think about what others
express, or feel about others' acts. These are called crossed interpersonal
relations.
Therapy goals
Improving client's communication and relationships, through:
1. Replacing crossed intrapersonal relations with direct intrapersonal relations.
2. Replacing crossed interpersonal relations with direct interpersonal relations.
Indications
All kinds of relational problems or discontents, relating to dating, family and
work relationships, and/or casual social encounters. In the case of problems in
stable relationships, both partners should be assessed and participate to
sessions, if needed.
Initial assessment
First, as always, you have to establish what is the main problem that led the
client to your office.
Second, you have to identify crossed relations within the person, and
between her and others. In the preliminary interview, you may want to ask the
client questions like:
Tell me if it ever happens to you to act what you feel? For example, to buy
something to the one you love, instead of telling her you love her, or just
letting that show in your gestures and facial expressions?
Tell me if it ever happens to you to express what you think, instead of acting
accordingly? For example, to try to show somebody through your body
language that you do not agree with her, instead of just saying it to her?
Tell me if it ever happens to you to feel about what others act, instead of
thinking about it? For example, to feel happy about a gift you receive from a
loved one on your birthday, as if it meant that he is loving you too, instead of
maybe just being polite?
Tell me if it ever happens to you to think about what others express, instead
of feeling about it? For example, thinking that if someone frowns, something
is wrong with her or with you, instead of just feeling that she is sad or
angry.
2. Today I decided that it's better for me to break up with my girlfriend, and
a. I'll behave so that she will leave me
b. I will tell her that
Client: The other day my boss frowned at me, and I wondered what was wrong. I
mean … did I do something wrong or what? I just accomplished all the tasks I
was assigned in the morning. Then I thought maybe he is not feeling well, he
is exhausted and is just upset.
Therapist: But he was just frowning, right? Why is it that this always has to
mean something? But what have you felt that moment? What feelings did
that frowning stir up in you?
C: I think I felt that he was angry . . . . I'm not sure I felt something. But I don't
understand why . . .
T: Maybe there is nothing to understand. Have you ever thought that way? Feelings of
others are meant to be felt, not thought about, right? Can't you just feel his anger
and move on, concentrating your thoughts - and I underline, your thoughts, not your
feelings - on what he is doing and saying? What effect do you think will that have on
you?
C: Maybe you're right. I don't know, I think that would make me less worrisome [he
smiles].
T: Now, the fact that you said you're not sure you felt something makes me think of
something else. How well do you know your boss?
C: Not so well. I started working there just a couple of months ago.
T: Maybe it's a good idea to find out if your boss is the one that is worrisome [the
client laughs].
Maybe by frowning he wants to make you understand that he indeed thinks your work is
not good enough, and frowning in this case expresses no feeling whatsoever. Has this
happened before? I mean, the frowning?
C: Maybe a couple of times, yes.
T: I think you have to try to know him better, to do a little research. See if this
is not something that he does with other employees also. If that's the case, you
have two options: to understand that when he frowns, it's about your work, or to say to
him that when he has something to say, he better say it, instead of frowning [the client
laughs].
Which one do you choose?
C: I don't know, I have to think about it [he smiles].
T: Then you'll have to go with the first [client and therapist laugh].
Here the therapist suspected that the client had a crossed interpersonal
relation with his boss, thinking about his emotional expressions instead of
feeling them, but then, when the patient declared that those expressions
were in fact not seeming to really express some feeling or emotion, he
investigated the possibility of a crossed intrapersonal relation on the part of
the boss, who seemed to express his thoughts through body language,
instead of acting them out or telling them.
I feel anxious and afraid [feeling], and I try to do something about it [action].
Feelings of helplessness, and later, hopelessness are generated by the fact
that the individual tries to act according to his feelings, and on his feelings,
but as feelings cannot be changed by voluntary action, he becomes helpless
and thinks nothing can be changed. Also, thoughts not acted out, and not
acted upon, give rise to pathological expressions (symptoms), because only
feelings - and not thoughts - can be really expressed.
First step: creating direct relations between thoughts, actions, feelings
and expressions (it's what psychoanalysis calls “interpretation” and
“insight”, and cognitive therapy – “restructuring cognitive schemata”)
I feel anxious and afraid [feeling], and I can't do it [go to college] [emotional
expression].
I want to go to college [thought], and I try to do something about it [action].
Second step: the result of direct relations is that problem ceases to
exist
I want to go to college [thought], and I try to do something about it [action].
Therefore, I don't feel anxious and afraid [feeling gone], and I can do it
[emotional expression gone]. When I'm afraid, I express my fear.
Treating anxiety and depression
Treatment Model for Anxiety
Before therapy: Crossed intrapersonal relations (pathologic)
I feel menaced, and I try to avoid the hazardous situations.
As there are hazards on the street (in the world), I have panic attacks
(symptoms) there.
During therapy: Direct intrapersonal relations (recovering)
I feel menaced, and I have panic attacks
There are hazards on the street, and I try to avoid the hazardous situations.
After therapy: Direct intrapersonal relations (healthy)
There are hazards on the street (in the world), and I try avoid the hazardous
situations.
Therefore, I don't feel menaced, and I don't have panic attacks (symptoms).
When I'm afraid, I express my fear (e. g. I'm shaking).
Treatment Model for Depression
Before therapy: Crossed intrapersonal relations (pathologic)
I feel depressed, and I try to do something about it.
As the situation is difficult, I cry all the time.
During therapy: Direct intrapersonal relations (recovering)
I feel depressed and I cry all the time.
The situation is difficult and I try to do something about it.
After therapy: Direct intrapersonal relations (healthy)
The situation is difficult and I try to do something about it.
Therefore, I don't feel depressed, and I don't cry all the time. When I'm sad, I
express my sadness (e. g. weep or cry).
Bibliography
Tapu, C.S. (2001). Hypostatic Personality: Psychopathology of Doing and
Being Made. Premier.