Therapeutic Presence Part 1

I’d like to talk a little bit about therapeutic presence. Since the 1950s the psychological literature has stated that people get better in a therapeutic relationship not by the technique that is used but rather by the presence of the therapist. What exactly is presence? In the contemporary therapeutic context there is a lot of research in what is now called interpersonal neurobiology. Everyone who is a therapist would be well served looking at the roster of books by the publisher Norton in their interpersonal neurobiology series. My personal favorites are Daniel Siegel’s book called The Developing mind: Towards a Neurobiology of Interpersonal Relationships. Allan Schore has also written several books on the subject and his latest is called The Science of the Art of Psychotherapy. Since much of this literature comes from research on maternal infant interactions, a book called The Birth of Intersubjectivity: Psychodynamics, Neurobiology and the Self is also a good primer in the field.

These books point out an amazing feature of the new science of therapeutic relationships and human relationships in general. And that is when we come into relationship let’s say with the client whether we are touching them as a manual therapist or speaking with them and some other therapeutic domain, we become a two-person biology. This means that our brains, hearts, vascular systems and autonomic nervous systems begin to synchronize with each other. It is therefore one of the important applications of this information that a practitioner or therapist be highly aware of their own body and its sensory processes especially while in the presence of a client. It is known from the work of Stephen Porges regarding the social engagements system that the first phase of any therapeutic relationship is the establishment of safety and trust through what he calls neuroception. Face-to-face contact, soft eye contact, body movements, breathing and facial expressions all lend themselves to the establishment of safety and trust. Without safety and trust the relationship will have a great challenge for producing therapeutic results. In part two I will describe the application of the research on mindfulness in establishing therapeutic presence and finally in part three discuss the research on compassion.

If you are interested in this topic, I am teaching a two day class on interpersonal neurobiology at the body therapy Institute in Siler city North Carolina. This will take place on June 11 and 12th 2015. For more information please visit my website at www.MichaelSheateaching.com.