Hi Shaman,

I found this a fascinating topic. I think that the "working alliance" is an important
part of my relationship with my T. The truth is, that the relationship with a therapist
is formed for a purpose, which is to help me function better and live more fully.
We come together in the first place, because of a common goal. The working alliance
is what I pay my therapist for; that he brings his time, expertise and insight into
how I operate so I can change that wish I want to. But I think a relationship forms
around the working alliance as you work together.

I often call it the therapeutic relationship when I speak of it, for good reason.
The therapeutic relationship is unique in my mind and it is helpful (but often very
painful) to remember that. It's not a friendship, it's not a romance, it's not a
professional relationship, it's not a parental relationship, although it has elements
of all of those relationships. I think it is closest to a parental one because of
the focus on the client's needs. But I think. for me, that relationship fits because
as time goes by and the trust goes deeper, my T and I have grown to know each other
and most importantly, I think love and respect for each other have come into play.

If I am honest, I feel the same way you do about referring to a working alliance,
because sometimes I just don't want my nose rubbed into the fact that this relationship
IS different and is based on my needs. Calling it an alliance reminds me of the boundaries
and limitations inherent in the relationship, which are often painful because of
my attachment issues and the grief and loss they evoke around old deprivations.

But I wonder if that isn't the very reason that a training program so emphasizes
speaking of the relationship that way. Therapeutic boundaries can feel very awkward
and wrong because they are unique. Therapist have to work very hard to keep their
feelings and needs out of the room, so by emphasizing that this is something different,
an alliance, than a relationship, this helps a training therapist to keep in mind
the need to behave differently in this relationship. I have seen countless times
the damage that can be done by a therapist who thinks it is ok to blur the line and
allow friendship or romance to enter into the therapeutic alliance, and it is always
the client who pays the steeper price for that mistake. So perhaps this emphasis
is used as a constant reminder to someone in training "this is not like your other
relationships, in fact don't think of it as a relationship, it is something different
and you need to behave differently." I have read a lot of things written by Ts who
have spoken of the fact that love is a necessary ingredient but they were never told
that in training, that is was something they learned as they learned their craft.
But perhaps it is better to learn that you can have strong feelings for a client
AFTER you learn the limits of how much of those feelings you should disclose.

Last note, I truly do have a deep visceral sense of gratitude for the boundaries
my T holds, and an understanding of how absolutely necessary they are for my healing,
but it doesn't stop me from sometimes being hurt, grief-stricken or frustrated by
them.

AG

For me, the word “alliance” has connotations of two people who don’t actually like each other working together against a common enemy. But once that enemy is vanquished, the alliance is over. It reminds me of the show “Survivor”, and how groups of people form alliances to beat the rest of the contestants, but then turn on each other.

I know some Ts like to use the word alliance to describe the nature of the relationship between T and client. It keeps the goal of therapy in the spotlight. From what my T has said (and from listening to how my friends have talked about their Ts), it is actually a pretty accurate description of the relationship for the majority of clients. People have a problem, they want help with it, and they don’t really care so much about the therapist as a person. To me, though, “alliance” does feel like a cold, distant term. Like I mean nothing to my T other than as a job. Like I am only using him as a means to an end. I don’t think either of those things are true.

I think the way AG describes it is apt. In the beginning, therapy definitely starts out as a working alliance. You and your T don’t know each other yet, all you have is the idea that you will work together for your benefit. And I think that for most clients, this is where it ends. The alliance gets a bit stronger, you and your T get comfortable with each other, but there aren’t deeper feelings. My good friend has been seeing a T for last year and a half. She sees her T every two weeks, and thinks nothing of the wait between sessions. Her T’s vacations don’t bother her. Whenever we talk about her therapy, it’s always in terms of what realizations she’s had about herself, or what she wants to work on, or techniques her T has taught her. She has a good working alliance with her T, but I would say that there isn’t really a relationship there. Her T feels more like a tool to help her than like a real person to her.

Whereas I’d say that 99% of my therapy is my relationship with my T. My T told me something a while ago that has stuck with me. We were discussing a dream I had had with him in it. In part of the dream, my T got a phone call from his partner, who had been out of the country in the dream and who my T was worried about. In the dream I was so happy for my T that his partner had called. When my T and I discussed the dream, I realized that because my T had been going through some really tough health stuff and hadn’t mentioned his partner at all, I was worried about their relationship. My T told me that none of his other clients would care about him like that, and then he said “that’s how I know our relationship is real.”

Personally the term working alliance offends my sensibilities so I am eager to know how the "alliance/relationship" gets defined/explained during the course of your studies.

I met with my own client yesterday. I had only met her one other time for 2 1/2 hours though we have spoken on the phone a number of times.

As we were getting ready to say goodbye, I wondered whether or not I should hug her goodbye. My natural inclination would be to hug her. I couldn't quite remember whether or not we hugged hello but had a vague feeling we did.

I decided that I would try to read her non-verbals. She did move towards me to hug me and I gave her hug in return, which I was happy to do. At that moment, I tried to imagine saying to her, "Oh, sorry, I don't hug. It's nothing personal. I don't hug anyone."

The thought felt so offensive to me. It seemed to me, that aside from a genuine fear of germs, that type of move is calculated to keep distance between therapist and patient. I know all of the reasons they put forth to try to explain it but, at the end of the day, it just feels like a cold way to behave towards people who open their hearts up week after week.

As an aside, my own T will not hug me goodbye. It's taken me a long time to get over the coldness of it. I am convinced that, aside from any risk management issues, it is a way to keep emotional distance from the client. Just my jaded perspective.

This is so interesting to me. I'm also in school (last year, yay!) and have thought about the therapeutic relationship often. Both from the point of view as a therapist and also as a client. A lot of my professors say "therapeutic relationship" but also a lot say "alliance" too. Honestly, it's often used interchangeably. I never really thought about alliance sounding cold, detached almost. To me, they were just words to describe the uniqueness of the therapy dynamic. But that does make sense.

I do think there is a developmental progression from a somewhat detached therapist to one that does love their clients. I've been in the field in some capacity for 8 years. I can say that I've grown so much personally and professionally. I show more of myself (genuineness, etc) to my clients. I obviously do work hard to keep my needs out of the room (that's why I'm in therapy!) but I think being real and not afraid to tear up (when appropriate and with someone who would not be overwhelmed with that display of emotion) comes with time and experience. I still have a long way to go in the growing department...but I've become more comfortable in my shoes and as a therapist. I do have genuine care for my clients. I do think about them outside of session. I feel sad for what some of them have gone through. I work with very medically sick and sometimes dying clients in a hospital. One of my clients died a couple weeks ago. I was sad. I cried. It is a relationship.

On the client side, I am so attached to my T. I don't always feel comfortable with her (hello negative transference ugh) but I do really care about her. I want her to care about me too. But I know that I am more attached to her than she is to me. That's just how it is. Logically, I know this (especially because I know what it's like to be the therapist) but emotionally, it still hurts. My T has talked about the "relationship" many times. She has said, "this IS a relationship." So I know she is not afraid to express that..to care, I think. Still, I know it's an unbalanced "relationship." I don't need my clients in the same way I need my T. I very much care for my clients though. Anyway, this has made me think, so thanks for the thread! Good luck in school...it's one hell of a journey.

I find alliance to be a stronger, steadier word and I liked the word 'union' in the definition.

I have relationships with so many people, like my coffee barista (we have a she makes my drink I'm eternally grateful relationship). They can be good, bad or neutral. Alliance sounds like same page, solid, safe, same goal (it also sounds mischievous, and a sort of special sharing you wouldn't with enemies or people "against" your cause). For example a country can have a 'relationships' but 'alliances' are much more. I feel it is like two links in a chain - to separate them is difficult.

Relationship feels impersonal for me. It could be just a bit of my intimacy fears here. Alliance gives me an inner feeling of safety to be vulnerable because of the solidarity I feel in my heart about it.

((((AG))))

I appreciate hearing about your experiences with your therapist and I'm sure others do too. Clearly, it's a painful topic for me and one I struggle with greatly in my own therapy. I get very disillusioned with therapy at times and with the nature of the therpeutic relationship. I KNOW my therapist loves me and/or cares for me deeply. That said, it wouldn't be honest of me to say that the touch topic is NOT painful for me which is why I can be a bit cynical about it and why I really believe that to some extent, it's for their protection, even if it is for our own protection as well.

I did speak very generally about all therapeutic relationships. I do believe, however, as you will see below, that I believe that certain things holds true not just for me but for all oppressed client populations.

The truth is my T says it IS a relationship. He doesn't call it an alliance. He has never told me that his family is more important to him than me. He doesn't work that way. I KNOW he probably feels that way but he doesn't throw it in my face. "Get over it, Liese. You will never be as important to me as my daughter." His mission is to make me feel important to him, worthy of his time and attention and he has done that.

He has gone above and beyond to show me that our relationship is NOT confined to 45 minutes/twice a week. He's called me after a rough session to make sure I'm okay. He has told me that he has internalized me and that I have made him a better therapist. How COOL is that? So, the truth is that this is probably all me projecting my feelings onto him and all therapists. Sometimes I feel like a very cold person, trying desperately to protect myself which it lends itself to all kinds of generalizations and feelings of despair and hopelessness. I have yet to envision what a healthy attachment looks like.

Staying with that for a moment, I know we are supposed to learn healthy attachment patterns from our T's. But I think my T is a bit avoidant. He's never been big on disclosure and sometimes I think he has lied about say why he took time off instead of being honest and saying, my daughter had a baby. I'm not sure about that but since I suspect it, it certainly affects his credibility in my eyes.

He told me this week that he is a very private person. It just really struck a nerve with me because there I am, disclosing all, feeling very powerless often, and he has the right to remain a very private person and that's just the way it is. I KNOW my feelings of powerless come from some of his choices as a therapist and it pisses me off. Of course, I also know some of it comes from me as well.

I'm not a big fan of therapy being all about my needs. Yes, at first until I could identify and learn to speak up for my own needs. But after that, I don't believe it's helpful. Actually, taking my T's need into consideration sometimes has made me a nicer person. Life isn't really ALL about me. I also think the "all about our needs" thing increases the sense of powerlessness. That aspect reinforces dependency. We are dependent upon them to meet our needs. Meeting T's needs gives me some power in the relationship.

Maybe power issues are much more a feature of my therapy than some of the other people here due to my incredibly powerless childhood. I don't know. I just know they are big for me and a big part of why I feel the way I feel. I do feel this way generally about the needs of oppressed clients and I'm not sure how many T's really think about the power issues. Even your T's refusal to give you a set appointment. I know it's worked for you even though you've struggled with it at times but I really don't get that. He's holding the rule book. It's not helping to empower you at all. Just reinforcing those feelings of powerlessness.

I can't change the nature of this therapeutic relationship though I could find a feminist therapist who thinks about power issues more than my T does and who believes that disclosure helps to equalize the power imbalance. However, I do have an amazing relationship with my T. He has worked hard to understand me. He's given me A LOT more than he had to. He could have terminated me a long time ago just as others here have been terminated. I have been no less needy than anyone else here and maybe even more needy than most. So I stay but it doesn't mean that I don't struggle with certain aspects of the relationship from time to time.


I do hope that you and/or I and/or anyone bothered by my/any post will learn to not let my experience or anyone else's invalidate your/their very valid and real experiences. As our own self of sense gets stronger, that will be easier to do and will come more naturally. I hope that all of us will learn to validate ourselves while empathising with others whose experiences with therapy are not the same as ours. We give our power away when we allow someone else's experience invalidate our own.

What's an oppressed client?

Your relationship with your T doesn't sound very oppressive to my ears/eyes... Ts help us grow not limit us (the good ones, anyway).

I don't particularly like either word because I think they are both too touchy feely, but the description of alliance is less distressing. I don't find alliance cold, but I do not see it as the therapist having an alliance with me nor do I really see her as what I would define as ally. I see her as a person I hire because she (I hope) has knowledge about how therapy can help and I do not.

Stoppers: (to what you said)

(((AG)))

Thanks for the support. It means a lot. I'm in a bit of a black mood today and I can't shake it. I've had a tough week. My Mom was in the hospital and we weren't sure she was going to make it. She just came home today though and seems to be doing okay. I have all the issues with my brother to deal with and it's been tough. I think when life feels out of control for me, I tend to pick on my poor T and therapy in general. Sometimes I think it's because it feels like the only thing I can control. I can quit therapy and get some kind of temporary relief but I can't get rid of my brother or make my mother do something she doesn't want to do. I just feel this incredible anger that I can't name though I think it might have to do with the relationship between the two of them and how incredibly powerless I feel. Sorry to vent. Just having a tough time.

((((AG), Nannabee, Liese, Erica, Catalyst, Dratggers, Stoppers, Tas))))

Hi everyone,

I don't have the time nor energy to reply to each of you individually. Nor do I have anything to add to the brilliant comments I've read to my question. They have really clarified the issue for me and gave me lots to works with for the future.
I'm at a bit of a loss right now. My wife and I had a painful evening last night and things aren't looking so good for us. I'm struggling to wrap my head around the idea of a break-up and how to keep on my feet emotionally, with the training only just starting and work pressure mounting, it's getting to be much.
I'll be around, but not too active.

Liese, thanks for explaining and lot's of courage to deal with your mom and brother.

(((AG)))(((SHAMAN)))

Thanks for the support. It's very much appreciated.

Shaman, I'm sorry things are looking so good for you and your wife.

What is an oppressed client?

((CAT))((RM))

I have been trying to find where I read that about treating oppressed clients. It had something to do with people who had basically been powerless throughout life and the special issues they have. If I find it, I'll post it.

I call it a relationship and have referred in therapy to "our relationship" and other times, "this working relationship". Really though, I don't think the label matters. No word can adequately capture what it is.

There is mention of a T internalizing their patient. What does that Feel like to the T a.d How would that affect the relationship??