The Healing Dialogue: The Therapeutic Relationship in
 Dialogical Psychotherapy


Josephine Newman

Let me begin by saying that dialogical psychotherapy is not a psychological 
theory about personal intrapsychic dynamics. Neither is it a technique or skill for
 repairing the wounds and vulnerabilities of our human psyches. It takes as given 
the rich store of scientific knowledge we now have at our disposal in these areas.
 The word ‘dialogical’, rather, points to the reality of the self as relational. And in
 talking about dialogical psychotherapy I want to focus on the implications of this
 for the therapeutic relationship.

The idea of the self as relational and dialogical is an old philosophical principle. It
 was eclipsed in the modern era by the notion of the self as monological – an idea
 which gave primacy to the autonomous rather than the relational aspect of the self.
 However, in contemporary thought the older principle has been revived and its 
central significance has been developed anew by some twentieth century
 continental philosophers such as Martin Buber, Emmanuel Levinas, Paul Ricoeur 
and many others.

In the area of psychotherapy, the insights of Martin Buber, in particular, have been 
developed at length by Maurice Friedman, Ivan Boszormenyi-Nagy and Barbara 
Krasner to name but a few. Roberto Assagioli, Italian psychiatrist and founder of 
psychosynthesis was a friend of Buber’s. His understanding of the self was 
remarkably similar to Buber’s in that it stressed the interpenetration of our
 existence as selves, our unity in multiplicity, and the process of synthesis that 
brings about this reality. In our practice of Psychosynthesis in Eckhart House we 
have given particular focus to Buber’s sense of the relational as dialogical and its 
role in realising synthesis. While other defining characteristics of the self remain
in place viz. the self as complex, dynamic, embodied, the self as relational and 
dialogical highlights the fact that the journey of self-realisation is always a journey
 in and of relationship with ‘other’, the other within oneself, the interpersonal other 
and the transpersonal other. It points to the fact that the self’s centre and core
 capacity to integrate and unify the multiplicity of its experience is activated in 
response to the ‘address’ of the concrete other. It is within this context that we talk
 of psychotherapy as a healing dialogue.

The Dialogical Self


First I would like to outline a few central elements in this idea of the dialogical self
 that are important in a psychotherapy context. Then I will talk about its
 implications for the therapy relationship as such. Buber’s central insight is that each
 person’s existence is unique and that equally we are partners-in-existence. We
 experience ourselves as real and truly present only when we relate to both these poles of our existence. However, to know oneself as unique one needs to be made 
present in one’s uniqueness by an other. For Buber, this is central. He calls it 
’confirmation of otherness’. The act of confirming is at the heart of true meeting and 
true relating. It means that each person in order to experience her or himself as
 person, must be addressed in this confirming sense by another. ‘Without being 
confirmed in this way by another’, he claims, we cannot know ourselves to be
 unique’. The point of emphasis here marks the difference between knowing oneself 
to exist merely as an individual rather than as a person. The latter happens only in 
a concrete confirming relational context.

The Atrophied Personal Centre

There is a connection between this and what Buber calls the ‘Justice of the Human 
Order’. Not only does every person need to be confirmed in this way; every person,
 as a matter of natural justice, is owed it, it is a natural entitlement. And, of course, 
the corollary of this is that every person has the capacity to confirm the other in his
 or her uniqueness. The immediate implication of this for dialogical psychotherapy 
is that the process of self-delineation, of realising the structures of the separate self
 – one pole of our existence as persons – is damaged and curtailed primarily by the
 absence of confirmation by significant others in one’s life, in particular, in one’s
 early life. A person’s psychopathology, consequently, can be discovered and 
addressed only within the context of a concrete confirming relation. In its absence 
the personal unifying centre of the human being will remain atrophied and the 
person will be unable to engage with others as partners-in-existence. Healing, for
 Buber, addresses and hopefully regenerates the ‘atrophied personal centre’.

Act of Inclusion


I’d like to look a little more closely, now, at the act of confirming the other’s
 uniqueness in relationship. For Buber it is primarily an act of inclusion, of
 creatively including in one’s own being the reality of the other without losing one’s
 own ground or centre as a separate self. Maurice Friedman, the most prolific writer 
on Buber’s work, stresses that inclusion is an act of creative imagination, not an act
 of ’empathy’ as one might suppose. It is ‘a whole imaginative swinging into the life
 of the other, so that one can, to some extent, concretely imagine what the other
 person is thinking, willing and feeling in the concrete now’. To be inclusive in this
 way is to be able to risk oneself to the other without guarantee of a response. We 
can say it is a willingness to be open, to be present, to be willing to address the 
other, to be addressed by the other and to respond to the address of the other. The 
capacity to build relational trust in this way and to restore relational trust where it 
is damaged is, for Buber, the central dynamic of healing the whole person.

Substitutes for Relational Trust


The word ‘relational’ and ‘relationship’ as we commonly use it does not necessarily 
mean dialogical. So when we talk about relational trust here we need to keep in
 mind its dialogical context. We are all fairly familiar, I imagine, with the more 
usual substitutes for relational trust. We often meet the other by leaving our own
 ground, for example, we take on other people’s thoughts and feelings in place of 
our own; we protect our own ground, close ourselves off and hold others at arm’s
 length. In psychotherapy too it is easy to bypass or misconstrue the relational. We
 can get caught up in analysing and resolving the problem the client presents. We
 can rely on our techniques or skills to build and restore relationship. In all of these
 ways we are objectifying the other by attending to them as contents of our own
 consciousness. That is to say, I am immediately present to my own thoughts,
 analysis or feelings about the other and not to the present concrete reality of the
 other. Buber’s focus is always on what happens between and not on what happens
 intrapsychically in either pole of the relationship. Introspective reflection and
 resolution of issues comes later.

The ‘Really Real’


It is obvious from this cursory glance at Buber’s understanding of relation and 
relational trust that commitment to the real is to the concrete reality of relation. The
 real is what happens in the meeting between persons. Any deviation from it in the
 form of relating through the veil of abstract and generalised ideas or through
 techniques and skills is a retreat from that existential commitment. He applies this 
in a very specific way to psychotherapy. The concrete meeting as persons of 
therapist and client is primary; it is the goal of therapy. Individuation serves that 
goal and not vice versa. Buber, of course, is not suggesting that we discredit, much 
less ignore, transference – counterference issues, or other intrapsychic dynamics in
the relation between therapist and client. Rather, he is saying ‘healing is through 
meeting’ and therapy which heals goes ‘beyond the repair work that helps the soul
 which is diffused and poor in structure to collect and order itself to the essential 
task, namely, the regeneration of the atrophied personal centre’. This can be 
attained ‘only in the person-to-person attitude of a partner, not by consideration and
 examination of an object’.

Limited Mutuality


Needless to say no dialogical therapist can, nor indeed ought to, promise to deliver 
on this! Real meeting is not something we can guarantee or switch on at will. 
Perhaps it is better thought of as a context which grounds the psychotherapy 
relationship. Awakening to the personal centre in its unifying and integrative 
function is a developmental process in body, feelings, mind, soul and spirit.
 Nevertheless, it can be addressed and related to as such in any moment of real
 meeting, not as an achieved or actualised state, but as an emerging possibility. The
 personal centre does not awaken spontaneously, but responds gradually when it is 
addressed. This is obviously true for both client and therapist as individual persons.
 But in the therapy relationship as such the act of inclusion in which the other is
 confirmed in his uniqueness, is not really mutual. Buber talked of ‘limited’ and
 ‘normative’ mutuality in relation to this. In his famous dialogue with Carl Rogers
 (1957) he disagreed with Rogers’ claim that full mutuality between client and 
therapist is the basis of the healing dialogue. For Buber though the relationship is
 mutual in the sense that the therapist, if fully present in an open, trusting and 
inclusive meeting with the client as person, the client herself does not – and indeed
 cannot – include, in any real sense, the therapist. If she does then the therapy
 relationship as such ceases. It must also be noted that the act of inclusion in which 
the client’s unique otherness is confirmed may require the therapist to move in the
 direction of a more challenging and confrontative level of engagement. This also 
underlies the idea of limited mutuality in the relationship.

Psychosynthesis Psychotherapy


In a psychosynthesis context the focus of address is the self’s unifying and 
integrative centre or core as body, feelings, mind, soul and spirit. Because the
 overall movement in this is synthetic rather than analytic, there is a real need to
 avoid any spurious short cuts to unity and integration. The full implications of the
 psychodynamic and developmental stages of the self’s formation must be adhered 
to and integrated. In the case of individual therapy in psychosynthesis this is
 obviously of central significance.

In addition to this if psychosynithesis is grounded in a dialogical framework, in the
 sense we have been discussing, then the practice of being present to the other will
 be essential. Let me say a word or two here about presence. Presence is a 
meditative stance, a practice and not a technique. The focus is on the one who 
practises and not on a goal to be achieved. One practises being centred by receiving 
into oneself the contents of one’s consciousness in the concrete moment. In that
 receptive stance, one identifies with the self who experiences rather than with the 
contents of the experience. This is often described as a practice of remembering 
who I am, or, of opening to the mystery of who I am, as body, feelings, mind, soul
 and spirit. It is important to stress that this practice of presence could easily become 
a mechanical repetition of words, or empty formula. If that happens it ceases to be
 practice and becomes a technique or skill to produce feelings of being centred in 
oneself. In reality, however, practice is opening to ever more inclusive levels of
 listening to the stories I tell myself about who I am in the concrete NOW, to telling
 and retelling the story of my past which shapes my present and opens me to receive 
and shape what is emerging for me. As such, a meditative stance becomes a way of
 life, a way of being present, which includes one’s process as body, feelings, mind,
 soul and spirit. It is a practice of gathering dissociated faculties in a more unified
 whole. The seeming paradox in this is that presence to self frees one from being
 preoccupied with self in its many identifications by being aware or and inclusive 
of them. In that dynamic of freeing one can practise attending to the other,
 concretely imagining what the other is thinking, willing and feeling in the now,
 thereby being present to the other confirming the other in her uniqueness.

Meditative Stance

Healing in a psychotherapy context, as we all know, is a very gradual process and
 can never be guaranteed. A major part of that process is concerned with self-
delineation – issues of bonding and separating which have originated in the client’s
 early formative experiences and have developed into neurotic blocks, interferences 
and obstacles in his personal life and relationships. In a dialogical context of 
meeting between therapist and client, the first element in addressing this level of 
the client’s experience is that of bonding. This means earning the trust of the client
 whose capacity to trust had been injured, by being there and available for the client, 
literally being trustworthy. It calls for openness and substantive flexibility in
listening to and validating the client’s experienced meanings in the events in his 
life, and the stories he is telling himself about these. A meditative stance in this
 will facilitate the therapist in staying in the present moment, in keeping at bay
 cognitive analysis and reflection on the client’s experience, which draws her away 
from the present moment. It will allow the therapist to suspend her own 
presuppositions, her own worldview and meanings and prejudices, in the moment,
 without abdicating them. It will, in this way, facilitate the creative imagination of 
the therapist to enter into the world of significant meanings of the client. It will 
create a space within and between therapist and client which can evoke the ongoing
 self-disclosure of the client. If there is real meeting as this process unfolds then the
 client will experience being confirmed and validated in his uniqueness by the 
therapist in the very mode of relating between them. Failure in this results in what
 Buber calls “mismeeting”. As a consequence, though the level of analytic
 awareness may have increased for the client, the personal centre will remain
 atrophied in that it has not been addressed.

Moving into Dialogue


The process of confirming the other in his uniqueness is, however, but a first stage 
in the process of becoming partners-in-existence. In being confirmed in his unique
 otherness a person is enabled to become truly relational by becoming, with others, 
partners-in-existence. Dialogue with others, engaging the difficulties experienced
 in addressing and being addressed by others, of responding and being responded to
 by others becomes part of the ongoing dialogue between therapist and client. It is
 a dialogue which evokes the client’s sense of self-in-right-relationship with others 
as body, feelings, mind, soul and spirit. It engages the client’s sense of being real 
in and through being relational.
This movement into dialogue with others, becoming partners-in-existence has,
 perhaps, for the past two hundred years or so has been dominated by a sense of
self as monological. The primacy of the individual and the contractual basis of our
 relationship with others in society had taken firm hold on our minds and
 imaginations by the early twentieth century. This has led the individual, in our day,
 to adopt an ethos of psychological introspection in search of personal fulfilment
 and happiness. It has left us with a heightened sense of ourselves as individuals and 
an undernourished, perhaps even dormant, sense of ourselves as partners-in-
existence. Buber’s dialogical approach to relationship and, in particular to 
relationship in psychotherapy is an antidote to this. From a psychosynthesis 
perspective I feel the emphasis on the dialogical is a significant factor in grounding
 the process of the self, as personal, as interpersonal and, even more importantly, as
 transpersonal.

Footnote.


References are taken from Maurice Friedman, The Healing Dialogue of 
Psychotherapy (1985) (Jason Aronson Inc. N.Y.)

Reference Books;

Friedman, M., The Confirmation of Otherness (1983, Pilgrim Press, N.Y.)

Friedman, M., Religion and Psychology (1992, Paragon House, N.Y.)

Buber, Martin, The Knowledge of Man edited by Maurice Friedman, 1965 Allen & 
Unwin Ltd., London)

Krasner, B.R., and Joyce, A.J., Truth, Trust, and Relationships (1995,
 Brunner/Mazel, N.Y.

Josephine Newman is a team member in Eckhart House, Institute of 
Psychosynthesis and Transpersonal Theory. She is also a lecturer in the
 Department of Philosophy in UCD.