Mindful Happiness

Anthony Quintiliani, Ph.D, LADC

  • Home
  • Dr. Anthony Quintiliani
    • About
  • Mindful Happiness
  • Mindful Expressions Meditation CD
  • Contact

March 16, 2019 By Admin

Psychodynamics of Alliance – Therapeutic Relationship Enhancement

Psychodynamics of Alliance – Therapeutic Relationship Enhancement

This post includes basic considerations, processes, and clinical skills necessary for developing a strongly positive clinical alliance and therapeutic relationship in therapy.  Here the alliance is required for any substantial change in psychotherapy, and the therapeutic relationship rides the quality of the initial alliance to expand and inter-penetrate the emotional b0nds between the client and the therapist. The combination of strong initial alliance and highly positive therapeutic relationship is a powerful enhancement for personal growth and positive change in therapy. However, it is doubtful that these factors alone will bring about meaningful change in the problem/s that brought the client into therapy. Without them, there will be no meaningful change.

Emotional Bonding and Therapeutic Presence Requires:

  1. Intentional empathic attachment by the therapist;
  2. Meaningful collaboration on important tasks and behaviors;
  3. Emotional exposure in safety, and emotional containment as needed;
  4. The client experiences being heard, cared about, and accepted unconditionally;
  5. The therapist provides a strong positive “holding environment” within “intersubjective space” (Winnicott);
  6. A social and psychological environment of mutual respect, compassion, and trust exists;
  7. The therapist may become a secure attachment (re-attachment) figure in this emotionally intimate process;
  8. The therapist’s “unconditional positive regard” is experienced and projected into the psychodynamic space (Rogers);
  9. The therapist may improve attunement with the client’s inner experience, emotions, and needs (Kohut); and,
  10. Within safety and trust both projection and projective identification occur (Alonso) as reciprocal introjective processes to ensure the potential for “going on being” (Winnicott).

Additional Specific Behaviors by the Therapist:

  1. Providing direct emotional support verbally and non-verbally;
  2. Holding a delicate balance in idealized projections;
  3. Rapid repair of emotional ruptures, and taking responsibility for same;
  4. Various forms of direct and indirect validation;
  5. Careful, strategic use of silence;
  6. Maintaining empathic understanding despite any negative countertransference;
  7. Working to improve “experience-near empathy” (Kohut);
  8. Acting on opportunities to improve the quality of object relations here and now;
  9. Serving as a “good mother” (or father) figure (Klein); and,
  10. Careful ongoing reflection on emotional, verbal, projective, transference, and countertransference processes.

Desired Self-Development Outcomes for the Client:

  1. Improved insight;
  2. Improved self-confidence and sense of security;
  3. Improved skills in mindful awareness;
  4. Reduced fixations on negative cognitive, emotional, and behavioral experiences in the past and present;
  5. Improved internal structure as well as object constancy and relatedness;
  6. More positive introjected experiences in therapy and in life;
  7. Reduced repetitive defensive and emotionally reactive patterns;
  8. Stronger, more positive sense of personhood; and,
  9. More effective views about self in the world of interpersonal life.

Caution: Most psychodynamic and psychoanalytic therapies place primary emphasis on the clinical relationship between the therapist and the client, and less emphasis on actual cognitive and behavioral change in presenting problems. Therefore, it may be a moral (not ethical) question as to whether a therapists uses only these approaches. It may be best to integrate them with a well researched evidence-based therapy. For supportive reviews see the work of Mark Solms, Edward Tronick, and C.A. Alfonso, R.C. Friedman, & J.I. Downey (Eds.) (2018). Advances in Psychodynamics Psychiatry. For a strong critique see Richards, A. (June, 2018). Psychoanalysis in trouble…Psychoanalytic Review, 102(3), June, 2018.

By David Rapp, Brian Tobin, and Anthony R. Quintiliani, PhD., LADC,

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon

Filed Under: Featured, Psychodynamic, Therapist, Therapy Tagged With: EMOTIONAL BONDING, MINDFUL HAPPINESS, PSYCHODYNAMICS OF ALLIANCE, THERAPEUTIC RELATIONSHIPS

Twitter

Mindful Happiness -Currently in Production

Mindful Happiness Posts

Loss, Grief and Suffering in America By Anthony R. Quintiliani, Ph.D., LADC Other than our nation’s suffering during The Civil War, The Great Depression, and World War II this past year has been one of the most stress-filled, fear-filled times in our history. Here is a list of the reasons behind it all: the COVID-19 […]

Vipassana Meditation – Emptiness One of the great insights from regular, long-term vipassana practice is the experience of emptiness. The actual knowing of it by the experience of it. This is not your typical conceptual emptiness of the West; it is not total void, negative beings, or nihilistic pit, or suffering in endlessness.  It is […]

Insights – Vipassana Mediation There will be future, more advanced vipassana meditations posted on the site. For now, however, we will end this series with a final post about the insights often experienced via vipassana meditation. We learn via experience about impermanence, suffering and its causes, no-self, emptiness and many other things – or, perhaps, […]

Vipassana Meditation:  Impermanence Although standard vipassana meditation practice leading to insight about the true nature of reality does not recommend what I am about to do, I plan to do it anyway. This meditation center is all about innovation in practice and generalization regarding the benefits of meditation for both regular meditators and novices.  Below […]

Brain Habits –  Helpful Vs Unhelpful Nora Volkow, MD, Director, National Institute on Drug Abuse ( video below)  has noted that people suffering from addictions may experience some dysfunction in in brain areas related to personal motivation, reward recognition, and inhibitory controls.  Neuroscientists have utilized various brain imaging techniques to document this possibility in addicted individuals.  These […]

Drink a Cup of Tea with Thich Nhat Hanh According to the article “A Perfect Cup of Tea” by Noa Jones, The Great Meditation Master offers this sage advice about the best way to enjoy a great cup of tea. I suppose if you would rather drink coffee, the same suggestions may apply. Recognize that […]

How to Offer Personal Tribute to Those Who Have Died The Four Noble Truths tell us sobering news. There is suffering, and impermanence of all things including us and our loved ones. Below I have listed several thing you can do to HONOR a person you have lost.  Here is the list. Recall a special […]

Trauma Therapy:  Basics from Some Expert Clinicians For many years trauma therapist have used many approaches in their psychotherapy. Most of these approaches lack strong empirical support for outcomes, and are often the “favorites” of these therapists.  One might wonder what benefits therapists derive from using approaches that are not evidence-based. If an intervention fails […]

More Psychoanalytic Gems – In an earlier post, I noted a list of Psychoanalytic Psychotherapy Gems, including a later post on D.W. Winnicott’s approaches to building a therapeutic alliance.  My general aversion to this form of therapy has more to do with its slowness and high costs than to its effectiveness. It is effective!  However, […]

In-Depth Means to Discover and Be Your True Self Henry David Thoreau reminded us that it is not what you look at, but it is what you see that matters. How do you SEE yourself?  John Muir reminded us that the sun shines in us as well as in our souls. Do you find “the […]

How to Find & Choose an Effective Therapist Recently The Harvard Health Newsletter posted some interesting questions to ask while seeking out a psychotherapist. I will add a few more details and areas of inquiry in this post. Keep in mind that these questions and inquiries do not mean you will be happy and improve […]

Mindfulness Expands the Art of Journal Writing T. Merton, J. Kerouc, I. Progoff, J. Upton, and others have helped to expand the art or journal writing practice.  This type of practice can become your mindfulness practice.  You will need to write on a daily basis (even if briefly), and you will need to be highly […]

Liberate Yourself with Spiritual Energy Cultivating authentic inner and outer peace is the only way to a happy and good future. Learn to use your spiritual higher self to let go of self-centerednesss, greed, and entitlement. Work to free yourself from the endless grasping for material “things.”  Does it really matter what kind of car […]

Mindful Happiness – Brain on Meditation Reports from various MRI and self-report measure studies support the proposition that your brain changes (neuronal plasticity) when you practice meditation on a regular (daily) basis.   The same is likely true when you practice yoga on a regular basis. Here are some noted changes in brain functioning that […]

Loving Kindness Meditation – More Thoughts Some less experienced meditators complain about how easily the mind’s wandering thoughts distract them from paying attention and deepening concentration.  This is a very common problem in meditation practice, and not always just for novices.  Here is a solution for you to try.  In Loving Kindness Meditation, you focus […]

Mindfulness and Concentration –  Experience Differences In this post I will explain some basic differences between mindfulness and concentration, both of which are required for effective meditation practice.  This will be the first of three posts dealing with what mindfulness and concentration are, how to experience them briefly in a body-based activity, and how to […]

Behaviors People Display When in Groups After more than 35 years of facilitating hundreds of classes, workshops, family therapy sessions, group therapy sessions, and work project groups it has become clear that we do some strange things when we participate in groups. It appears to me that many of these in-group functions serve both ego […]

Building Healthy Intimate Relationships: Intimate relationships are often the source of many years of happiness and satisfaction, and sometimes the cause of great pain and suffering. It depends! I will list various realities of initiating and maintaining a positive intimate relationship.  After reading these, ask yourself: Where is my relationship? If you are unhappy, do […]

Trauma Informed Care – The Absolute Basics This post aims at providing a very basic introduction to Trauma Informed Care.  Advanced versions of this information are available from the author.  So what is Trauma Informed Care (hereafter TIC)?  Below I have listed rationales of need and core characteristics of TIC in organizations. Why We Need […]

Wise Mind and the Neuroscience of Mindfulness Practice What is wise mind? Marsha M. Linehan developed this clinical process in her work on dialectical behavior therapy. Wise mind is the middle way between rational/reasonable mind and emotional mind; it allows us to live with balanced reason and emotion in daily interactions. When practiced regularly, it […]

Mindful Categories

Mindful Happiness Pages

  • About
  • Contact
  • Dr. Anthony Quintiliani
  • Mindful Expressions Meditation CD
  • Mindful Happiness
  • Site Map

Copyright © 2023 · Mindful Happiness