All Interventions are Relational Acts
While there are many specific interventions that can be helpful, one of the more important principles is the recognition that the alliance and technique are interdependent. All interventions are relational acts. The meaning and impact of the therapist’s intervention is always shaped by who both the client and therapist are, what they are both experiencing in any given moment, and how they are perceiving themselves and each other. Perhaps the most important overarching principles is for therapists is to continuously reflect on how clients are experiencing their interventions, as well as how their own feelings in the moment may be coloring their interventions.
A Dyadic Systems Perspective
The therapist is not a neutral or objective observer who can formulate the patient’s problems from an outside perspective. Psychotherapy takes place in the context of a an interpersonal field that the therapist is part of. Patients and therapists are always influencing one another at both conscious and implicit levels. There is an ongoing process of implicit mutual influence that takes place partly through nonverbal communication. Therapists are typically only partly aware of the roles they are playing in shaping this interpersonal field, and one of the critical tasks is for them to work towards developing a better understanding of how they are influencing this field over time.
Rupture and Repair as a Natural Developmental Process
Observational research of nonverbal communication between infant-caregiver dyads finds that there is a process of mutual influence that involves ongoing cycles of affective coordination and misco-ordination (Tronick, 1987). Mothers and infants are affectively coordinated only 30% of the time. Misattunements are followed by interactive repairs approximately once every 3-5 seconds. In health mother-infant dyads, periods of misattunement are regularly followed by interactive repair. In insecure attachment relationships, periods of misattunement tend to be followed by more misattunement. Ongoing cycles of attunement-misattunement and interactive repairs, play an important role in helping infants to develop a relational schema in which the other is represented as emotionally available in the context of the inevitable ruptures that take place, and the self is represented as capable of negotiating relationship ruptures.