Client and Therapist Relationship

by Alexandra Gusinsky,
Registered Psychotherapist

January 2020

A warm welcome!

I was very happy to take this opportunity and to talk about one of the most important aspects of the relationship between a client and a therapist, the holding relationship. When I explain some of my favourite psychotherapeutic ideas to clients, they find them interesting, illuminating and – best of all – directly helpful. These concepts might sound theoretical, but they are incredibly practical.

The power of psychotherapy lays in the presence that deep listening offers. Being listened to, being understood, being seen for whom you really are, and receiving accurate and kind feedback is balm for the soul. One of the central concepts in psychotherapy is “holding”.

What does “Holding,” mean in therapy?

In psychotherapy, holding refers to emotional and mental holding. The therapist offers emotional holding, while being present with you, recognizing and understanding what you are feeling, in a respectful, safe and accepting way.

The concepts of holding and containing developed from observations of mothers caring for their young children. One of the things good mothers do is help children to feel safe and confident by managing their upset feelings for them. The child is not left to struggle with difficult feelings alone, as the mother helps the child to make sense of her feelings and learn to manage them. In therapy, the therapist will help you manage emotions that you feel you are not coping with, such as confusion, depression, anxiety or anger. The way this is done is through offering a holding relationship, where the therapist is reliably present, consistent, safe and trustworthy, and is attuned to your individual emotional climate.

Holding is a word psychotherapists use to denote a very specific meaning that comes from developmental psychology. Infants benefit from being picked up, carried around and cuddled as much as possible. This normal high level of frequent physical contact helps them to feel secure and to thrive. Our understanding of the importance of holding has partly developed from the observation of infants and young children and the effects of close contact, or its absence. As a child grows older, the mother will cease picking her up every time she cries, because she knows the child has internalized the good sense that mother is there for her, and will be able to cope with minor upsets independently. But if a child was not comforted sufficiently when she was younger, she may not ever cope so well with upsets and may need to resort to self-soothing strategies to manage her feelings.

In psychotherapy, holding refers to emotional and mental holding. The therapist offers emotional holding is being present with you, recognizing and understanding what you are feeling, in a respectful, safe and accepting way. A therapist will not change the subject and ask you what you had for lunch if you say you feel a bit sad today! As your therapist I will stay present with you, with whatever you are feeling, and also show that I am interested and accept your feelings – they are both real and important. By staying present and attentive to their feelings, I enable my clients to do the same for themselves – feelings that they found difficult to articulate or cope with can become much easier to make sense of.

Mental holding is more like “holding you in mind”. The therapist is attentive and present to thoughts about you. I remember you and think about you between sessions and do not forget all about you between sessions. I remember some important details about things you have told me, and make connections between things that are occurring for you now and things that occurred in your past. Mental holding is about the ability to make connections, or bridges, between different aspects of experiencing. By doing this with you, the therapist facilitates you to be able to think more freely about yourself, and revise your concepts of who you think you are, so you find it easier to solve problems and tackle things that you want to achieve

How does holding come into the therapy room?

I will hold you in a way that is consistent and attentive, but not overwhelming. I will be careful to attune to you and the level of emotional and mental contact you feel comfortable with.

The therapist can see aspects of your emotional history fairly clearly, even before you have spent much time together. I will notice the ways in which you respond to what I say to you. For example if I say something kind or complimentary, do you bat it away or ignore it, do you feel irritated that I am flattering you, does it make you cry, or do you receive it and reflect upon how it makes you feel? I am really interested in reading all the clues that evoke the kind of emotional climate you create around yourself. Clients who have not experienced sufficient secure holding as children may not even recognize what the therapist is offering, and think she is just being “nice” – and it can take some time to find out what holding is and what it feels like.

As a therapist I will attempt to provide a holding environment during our time together. This refers to the physical space, which is private and protected, and the therapeutic relationship, wherein you are supported and safe. Because of the steady presence and calm attention of the therapist, you are able to explore and express emerging feelings and thoughts, which may be more accessible to you in this space because you are offered empathy and acceptance. At the same time as tuning in to your emotional world, I will also stays grounded as myself, so I continue to feel safe and confident even if you feel a bit overwhelmed by your feelings.

This aspect of therapy can sometimes surprise clients, as they find themselves easily discussing feelings and experiences, which they have never felt able to disclose before. When you have the experience of being held in this way, you can often very quickly see yourself more clearly, and reorganize yourself internally. Through this process you get to know yourself better and revise your self-concept so that you feel more up-to-date with where you want to be in your life. This can save you a lot of time, as you can move quite swiftly through emotional blocks that were holding you up.

 

I hope you enjoyed this article.
Please let me know if you need help or have additional questions.

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Alexandra Gusinsky