Research has shown that interpersonal skills of a therapists contribute far greater success to a therapeutic outcome. You can read this book for more clarification.

Fuster, J., M. (1998). Personal Counselling. 8th edit. Mumbai: Better Yourself Books.

Yes....you are right in saying that ..

The therapeutic relationship in itself is curative..... infact it has been found to be more effective than specific techniques used in psychotherapy. The therapeutic relationship is responsible for bringing 40% change in the client whereas specific technique just brings 15% change. (Lambert, Handbook of psychotherapy and behavior change)

Generally,if we are suffering from something,we are looking for help.Any suffering impairs the

realization of our intentions(programs, wishes,destenies)in everday life.Therefore,a

patient has subjective expectations concerning

a person who can help.In other words,a therapeut

or doctor must be appropriate or sympathetic in

the real sense of the word.Here we deal with a

feeling of the patient that often decides in the

first contact with the therapeut,if the therapeutic

process becomes successful or not.

A good therapeutic communication generates

confidence.Confidence may exert the basic

therapeutic effect improved by a therapeutic

methode.

Thank you for all your inspiring comments!

Talking from my personal experience, even a bad relation can be better than psychoanalysis... :)

Well Hilde, I regret I agree with you, since I was trained as a psychoanalyst—and therefore I could/can see all psychoanalysis' shortcomings from inside. Could you perhaps be a little more detailed about your experience? In the terms in which you expressed it, it seems that psychoanalysis means NO relationship between therapist and client—which unfortunately is exactly what I often saw/see in my field. (Of course “no relationship” is actually impossible—therefore I would better talk of very stiff and constricted relationship). Did you mean something like that?

This is based on my own experience with depression but positive friendships have been more curative than therapy. I have never been in psychoanalysis so the therapy was general in nature.

It certainly is not a plea against therapy! I wouldn't keep on doing it if I didn't believe in it. But yes, I mean that so called 'blanco screen'; the illusion that you can withdraw yourself from the contact - I understand the rationale for it. It is not fruitfull to satisfy the needs of a client instead of exploring them. That would make the client dependent. But you can do the exploring in a supportive way without the need of being seen as the expert...

What I react against is the whole trend of so called obvective protocols in which the person of therapist or the quality of the relation wouldn't matter. It is, I believe, the main factor. Therefore, yes, relations are often better than therapy. Group therapy is a way of combining the two...

These are two different things. I've worked as psychodynamic psychoterapist under supervision from Polish Psychoanalytical Association. Psychoanalysis is more complicated and difficult.

Empirical evidence suggests psychotherapy being helpful for many patients. No matter if it is psychodynamic, behavioral etc. It also seems to be that not technique is the most important factor but the quality of the relationship accomplished by the two participants as Pradip Gupta noted above. If clinical training improves therapist's abilities to handle therapeutic relationships in a good way, then we are on a good way. Nevertheless we also now that 20% of our patients do not improve or even get worse. We have to be honest about that with our patients , have to work on understanding the reasons, but probably also have to accept that 100% success may be not from this world.

By the way: there is a long tradition in psychoanalyses in criticising "stiff and constricted relationship". Starts with Michael Balint and others and leads to self psychology, relational and intersubjective psychoanalyses.

I think the origional uestion is not quit framed right The research is clear the the quality of rapport between therapist and the client is the most importent factor over specific tech there is a difference that can make a differnce by providing a safe place to do inner work and or learn skills to self regulate I recently had a patent who has a number of good close friends that therapy has kept her from "killing myself because I could talk about my feeling in this space" So it is both the relationship and the specal relationship/context of being in therapy and a dash of the right skills.

Scott D Miller is one who has conducted the research in this aria good stuff and it works to make therapy more effective

The problem is what is good for a patient not always is a good thing for a psychoanalist and vice versa.

You cannot be only good for your client as a friend for example.

The person want to kill himself. Do You like him all this time?

Thank you Hilde for your answer. (And I like group therapy).

Thank you Martin for your honest and useful and relaxing statement about failures. I strongly resonate with it, and I rarely find clinical statistics and accounts about treatment failures. I regret that on the contrary I often find a theoretical orientation claiming overall superiority compared to different therapies.

Which I think is unfair and false.

Our analytic literature notwithstanding, many colleagues are still working too little intersubjectively in my perception ...

(I belong also to the ICCE community Mike).

Adriano

here is Dr Mill's web site very parctical stuff for any orientation http://www.scottdmiller.com/

Only when Your friend works as active psychoanalist.

In the perspective of attachment theory, insecure attachment can be changed to "learned secure attachment" via psychotherapy and/or via a secure and supportive relationship.

So both are good - I don't know if there are ways to measure which is better. It is probably at least as hard to measure quality of relation as it is to measure quality of therapy...

You may read Jerome Frank's Persuasion and Healing for a classical work disseminating the roots of relational sources of improvement from different forms of demoralization, whether it is friendship, miracles, or psychotherapy. In addition, whether a friend is better may depend on the type of problem. I remember Arkowitz arguing that depression may respond especially well to general factors. Back in 1992 he even suggested a Common factors therapy for depression, devoid of theory-specific interventions in Norcross and Goldfrieds' Handbook of psychotherapy integration. I remember it as a thought-provoking read at the time.

I think we can say that there can not be any effective therapy if there is not a good relationship between the patient and the therapist. In other words...

Non-specific factors are by far the most important elements in psychiatric treatment. One of the greatest damage done by the EBM is that it helped to debase the human relationship with the patient

This is what I was taught as a trainee psychotherapist but I remain unconvinced that that's enough. Nevertheless, while training I had an experience of the reverse and that I feel can certainly be damaging.Not all analysts are equal, some are a repeat of initial bad relationships with parents.

It is universally accepted that every patient has his own treatment. At the level of many diseases, especially cancer, there are many factors that affect and are affected by any disease or pathogen. There is no doubt that genetic factors / immune system / environmental and social factors play an important role. Accept any type of treatment, because the confidence factor is the most prominent success of any method, which may be more available with close relatives and close friendships and social relations. And of course trust between the patient and psychotherapist and the plan is essential for the success of treatment

Good relationship heals every problem..............means good relationship is better far far better than psycoanalysis.

Though I am not a psychologist/psychotherapist but I want to suggest that good relationship always gives better results and keep someone in good state of mind.

I certainly believe that psychotherapy is the right treatment for a number of conditions, with a democratic edge and less liability towards patient damage than psychiatry, but I grew to suspect any form of treatment that is tinged even slightly with ideology. If a therapist is there to learn, good enough, if there to teach a ? Human psychology is undecided, that is there are many reasonable ideas on the subject, and insisting on a single one (here I go back to psychiatry-the most damaging of all treatment-forms and the least able to acknowledge the fact as an entirety or separately)can lead to patient harm.

Yes, a good relationships are better than psychoanalysis.

man is not with perfect nature. Man has flaws in his nature some extent; man reacts with immaturity, unable to resolve conflicts, unable to come up to expectations, unable to decide well in certain situations, in this situation psychoanalysis helps to know the reasons behind every action or reaction. this analysis might be biased at some moment because human nature is too much complex to understand so it is better to have good relations than psychoanalysis.

Yes you are right dear Michal Patarák . In therapy, the very common hing is that you go there to find out about yourself, and each session is designed to make you question your life and attitude. It can be very irritating to be the partner of someone in therapy because that questioning mood lasts for hours or days after a session. There is a huge likelihood that aspects of your relationship will come under some very close scrutiny. All you can do is be supportive and ride it out. But, you aren't imagining it.

Abdallah Hussien Fathy did you attend psychoanalysis? Can you have a good relationship based on mutual respect and equality if you do not know yourself? Can you accept the other person's bad traits if you are unaware of your own?

really wrong question good relationships are nessisary for ones mental and physical health and psychotherapy in its many and varried orm can be nessisary for somef

Interposed questions: what is characterizing a good relationship? Do people able to maintain good relationships enter therapy?

Dear Martin,

The relationship may appear to be good because one is the taker and the other is the giver till the second is so alienated from herself and has no needs met and is obliged to enter psychoanalysis.

Pradeep Gupta

Psychoanalysis is NOT a special technique, it is the foundation of the other so called techniques.

The basis of successful therapy begins with good relationship or rapport. That one thing can not fully be documented but it certainly seems to work well.

Oh it has been documented see Dr. Scott Millers work and extensive research the relationship after client chariteristics is most importent varable in perdictiong out come of therapy way past type of therapy and tech used

And I think this (Ganesh, Mike) is the foundation Béatrice Marianne. For instance also Gelso, if I'm right. Rogers. And many others. But I'm still struggling with my psychoanalyst colleagues about that—they go on ignoring psychotherapy research.

Adriano Bugliano,

Aaron Beck and Albert Ellis went themselves through psychoanalysis, which is long, hard and costsam, at least when it is orthodox as in Finland.

I suggest that you study first and then present your opinion. We do not benefit from free phantasies on RG.

Dr. Aaron Beck’s Transition from Psychoanalysis to Cognitive Theory

May 21, 20140 Comments/by Andrew Bartosh

During a recent Beck Institute Workshop, Dr. Aaron Beck describes how he transitioned from psychoanalysis to cognitive theory. Dr. Beck explains that his transition period spanned two years and began when he discovered a lack of empirical evidence supporting psychoanalytic theory of depression. He subsequently began to question the effectiveness of psychoanalysis in the treatment of depression. In 1963, Dr. Beck published “Thinking and Depression: Idiosyncratic Content and Cognitive Distortions” in the Archives of General Psychiatry, widely recognized as his first publication on Cognitive Therapy.

In point of fact, psychoanalysis is a whole collection of theories that inter-relate - and so are all of the other "schools" of therapy. To think that if one of the subtheories is wrong, then they all must be wrong, is black and white thinking - something cognitive-behavioral (CBT) therapists themselves label as irrational.

From psychology today

Aaron Beck (the father of CBT) attended Brown University, graduating magna cum laude in 1942. Beck attended Yale Medical School, graduating with an MD in 1946.

He began to specialize in neurology, reportedly liking the precision of its procedures. However, due to a shortage of psychiatry residents he was instructed to do a six-month rotation in that field, and became absorbed in psychoanalysis, despite initial wariness.

The most important psychologist for Beck was Albert Ellis, whose own faith in psychoanalysis had crumbled by the 1950s. He had begun presenting his "rational therapy" by the mid 1950s. Beck recalls that Ellis contacted him in the mid 1960s after his two articles in the Archives of General Psychiatry, and therefore he discovered Ellis had developed a rich theory and pragmatic therapy that he was able to use to some extent as a framework blended with his own, though he disliked Ellis's technique of telling patients what he thought was going on rather than helping the client to learn for themselves empirically. Psychoanalyst Gerald E. Kochansky remarked in 1975 in a review of one of Beck's books that he could no longer tell if Beck was a psychoanalyst or a devotee of Ellis. Beck highlighted the classical philosophical Socratic method as an inspiration, while Ellis highlighted disputation which he stated was not anti-empirical and taught people how to dispute internally.[17] Both Beck and Ellis cited aspects of the ancient philosophical system of stoicism as a forerunner to their ideas, though Ellis wrote more about this; both mistakenly cited Cicero as a stoic.

In 1967, becoming active again at UPenn, Beck still described himself and his new therapy (as he always would quietly as neo-Freudian in the ego psychology school, albeit focused on interactions with the environment rather than internal drives. He offered cognitive therapy work as a relatively "neutral" space and a bridge to psychology. With a monograph on depression that Beck published in 1967, according to historian Rachael Rosner: "Cognitive Therapy entered the marketplace as a corrective experimentalist psychological framework both for himself and his patients and for his fellow psychiatrists."

https://en.wikipedia.org/wiki/Aaron_T._Beck

Probably I wasn’t that clear Béatrice Marianne.

It wasn’t that easy in two sentences, but I didn’t want to overburden the forum.

I was simply pointing at what in—my opinion—is the main psychotherapy issue today: integration upon the basis of the relationship. Since it is precisely research that is pointing from all sides at the value of the relationship as a (the?) critical factor (foundational?) in any kind of therapy practice.

Am I wrong?

And relationship is before human (and animal) than clinical. Isn’t research (e.g. neuroscience) precisely pointing at that? That the brain develops in an emotional responsive and relationally engaged environment? Briefly, that our brain/psyche needs emotions and relatedness on a natural evolutionary base? (Allan Schore, Dan Siegel, Jaak Panksepp, Eric Kandel, Vittorio Gallese, The Boston Change Study Process Group, Giovanni Liotti, and many others).

I know very well that psychoanalysis is the historical basis—everyone comes from that, directly or indirectly.

But I don’t know if it’s correct to say that psychoanalysis is the foundation today. (And I AM a psychoanalyst, however integrative).

Since psychoanalysis, in itself, doesn’t value the relationship that much (one-person frame too much focused upon transference, as I think you wrote in another RG forum). Only a side of psychoanalysis is valuing two-person relatedness today, and still with many conflicts and lack of coherence. I can say that from inside, since my association, IARPP—International Association for Relational Psychoanalysis and Psychotherapy, is collecting all the relational and intersubjective analysts on this planet.

What about attachment theory, affect-regulation, infant-research, trauma studies, mentalization, and so on? All this is STILL partly challenged by psychoanalysts.

John Bowlby, coming from psychoanalysis himself, was attacked for years by psychoanalysts.

When I share with colleagues and also write about my way of practicing they often become aggressive and defensive about what they call my “analytic transgressions”, even though I’m supporting my clinical choices with MUCH psychotherapy research of any kind.

Scott Miller included.

Therefore, I totally agree with you about black and white thinking and schools.

I have a CBT colleague in London, Richard Hallam, who writes that today EB-obsessed CBT is totally different from old times one, when it was much more pragmatic, human, and Socratic.

I am working hard in any situation with colleagues (this forum included) towards integration and open-minded collaboration amongst therapists, and any kind of research and practice integration is what I think is the most important thing today.

I think that clients needs that, instead of market turf wars between groups.

And this is a meta-issue that cannot so simply be solved by research itself, isn’t it?

Do you think this is “free phantasies”?

Adriano

Excuse me for expressing myself in a clumsy and rude way. I did not mean to hurt you. Psychoanalysis and CBT approach symptoms from different angles.

While psychoanalysis is occupied with unconscious or preconscious ideas and not at all interested in symptoms (which though may drop off during the analysis) CBT is learning based and symptom focused. This is why Aaron Beck et co. went for a short-cut that was symptom focused.

I have some difficulties with your language. I do not know if I understand you properly.

The mean time for psychanalysis in our country is now 7 years 4 times a week, You can be absolutely sure that attachment -or lack of it- is reflected and repeated during the process; so is affect-regulation, infant-experiences and traumas. After that you can move on to your PTSD growth and use everything you understood during the long and hard years. It is though a different way of thinking in the psychodynamic approach compared to that learning-based therapy.

I agree with you completely that building a strong personal relationship is much better than psychological analysis as the construction of this relationship will create a bridge of trust with the patient and thus able to get what the patient in a normal way and without the hides or hide anything and as a result we can treat his condition without feeling that we are suffering from Psychological condition suffers.

Béatrice I really appreciate your repair and I always welcome straightforward confrontations. That is precisely relatedness! I think it's relieving and healthy.

And simple.

Thank you so much.

I'm not hurt. You just challenged me, and I felt engaged. You did well.

Some are integrating CBT and Psychoanalysis in a very structured way and flexible at the same time. For example, Paul Wachtel in the USA. Stanley Messer also in the USA. Both active on ResearchGate.

I am Italian (Firenze), so my English is surely not good enough. And above all I have a kind of weird irrational mind.

Therefore I can understand if you have problems with my English!

By the way, do you come from psychoanalysis yourself? What are your roots? I would like to know that—when and if you have time.

Adriano

Glad you are not hurt. Yes, I have been through a long psychoanalysis but also have 4-year training in CBT. So I am familiar with both ways of thinking.

Best regards from Finland, my youngest son is in your country just now:) . Sweden and Finland were combined for 600 years but now the Finnish language takes over. A minority of Swedes are left here but it is more convenient to work in Sweden.

Not hurt at all, since I felt the taste of a good interaction, that is, your responsiveness—good interactions are the juice of the matter and it is critical to pay attention to them.

Glad to know about your trainings. And I think that sharing real training and practicing (and life) experiences with real flesh and bones colleagues adds a critical side that papers and books are mostly missing.

Hello,

I don't think we can compare "relationships" with "psychoanalysis". Psychoanalysis is quite straightforward, where the therapist knows how to handle patients. The therapist is well aware about the mental status of the patient and deals and analyses in that manner. Relationships on the other hand, can get dilly-dally with time and cannot be compared with a meticulous psychoanalysis.

Regards,