Relational Psychotherapy Relational Psychotherapy: A Primer, 2nd ed., offers a theory that is imme- diately applicable to everyday practice, from opening sessions through intensive engagement to termination. In clear, engaging prose, the new edition makes explicit the ethical framework implied in the first edition, addresses the major concepts basic to relational practice, and e lucidates the lessons learned since the first edition’s publication. It is the ideal guide for beginning practitioners but will also be useful to experienced practitioners and to clients interested in the therapy process. Patricia A. DeYoung, MSW, PhD, is a relational psychotherapist, clini- cal supervisor, and a founding faculty member of the Toronto Institute for Relational Psychotherapy. This page intentionally left blank Relational Psychotherapy A Primer Second Edition Patricia A. DeYoung Second edition published 2015 by Routledge 711 Third Avenue, New York, NY 10017 and by Routledge 27 Church Road, Hove, East Sussex BN3 2FA Routledge is an imprint of the Taylor & Francis Group, an informa business © 2015 Patricia A. DeYoung The right of Patricia A. DeYoung to be identified as author of this work has been asserted by her in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopy- ing and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. First edition published by Routledge 2003 Library of Congress Cataloging-in-Publication Data DeYoung, Patricia A., 1953- Relational psychotherapy : a primer / by Patricia A. DeYoung. —Second edition. pages cm Includes bibliographical references and index. 1. Interpersonal psychotherapy. 2. Interpersonal relations. 3. Psychotherapist and patient. I. Title. RC489.I55D495 2015 616.89'14—dc23 2014040947 ISBN: 978-1-138-84042-3 (hbk) ISBN: 978-1-138-84043-0 (pbk) ISBN: 978-1-315-72370-9 (ebk) Typeset in Minion by CodeMantra Dedication To Mary B. Greey This page intentionally left blank Contents Preface to the Second Edition viii Preface to the First Edition x Introduction 1 1 Relational Therapy and Its Contexts 11 2 Beginning with the Basics: Structure, Ethics, and Empathy 44 3 Assessment: What’s Wrong When Your Client Feels Bad? 61 4 Relational Trauma: Past and Present, Memory and Now 84 5 The Terribly Hard Part of Relational Psychotherapy 109 6 The Wonderfully Good Part of Relational Psychotherapy 134 7 Ending and Going On 160 8 Twelve Years Later 172 Bibliography 209 Index 213 Preface to the Second Edition When Anna Moore, my editor at Routledge, asked me if I would be will- ing to develop a second edition of Relational Psychotherapy: A Primer, I answered, “Yes, but there’s this manuscript on chronic shame I’ve been working on for a while. I think I should finish it first.” Anna trusted my instincts, I buckled down to write the shame book, and then I turned to this project. I didn’t imagine then that the two books would be linked. I simply felt that I had cleared my mind and would be able to speak in my own voice going forward. When I considered the Primer revision, two things came to mind: (1) Twelve years haven’t changed the basic principles of relational practice. (2) Twelve years have brought subtle but significant changes to how rela- tional theory is articulated. Could a revision do justice to both realities? Would I start from the beginning of the Primer and try to weave these subtle changes into the original text? I thought not. It might be easier and more useful to write a completely new book! How then to revise? I proposed an experiment. I would draft a new last chapter (Chapter 8) that would summarize key new articulations of rela- tional theory, explain how they interact with previous theory, and illus- trate the changes with some case material. We would then send the new chapter, along with the first edition Primer, to impartial reviewers to see whether the experiment worked, whether this new format would extend the cogency and usefulness of the first edition. Anna welcomed the idea. I felt liberated to write—and grateful that she once again believed in my process. As I worked my way through the four new ideas I wanted to address, exploring their impact on the overall system of relational theory, a certain case kept coming to mind unbidden. Not only did it illustrate the theory in question, it was also a case discussed in the first edition. Thus it could be a perfect example of how new theory creates new meanings, even from mate- rial already understood in relational terms. It was, however, my own case, Preface to the Second Edition ix the impasse with my analyst I had written up in Chapter 5, an event I could now acknowledge as a tsunami of shame that took me years—and writing a book—to understand. I wondered: What kind of narcissism would lead me to write about myself again? What kind of shame am I still exorcising? And so I couldn’t quite write the case, though my head was clear enough to see connections between my case and the new theory, and I had voice enough to speak what I saw. But then, thanks to my peer supervision group—Judy Gould and David Schatzky, who encouraged me to take an hour to speak my case to them, and Bonnie Simpson, who wholeheartedly endorsed my first nervous draft—I could write it. Off it went to the reviewers, and their solid support of the project in this form was a great relief. Thanks to Steve Tuber for his helpful questions about the connections between mentalizing, empathy, and compassion. Thanks to Donna Orange for the warm welcome she gave to my personal story and for linking the chapter to an “ethical turn” in relational theory, which inspired me to add the final section, “The Ethics of Showing Up.” Many readers of the Primer’s first edition, mostly students of the Toronto Institute for Relational Psychotherapy (TIRP), have asked me after reading Chapter 5, “So what happened? How did it turn out between you and your therapist?” I’m happy finally to be able to give them substantial answers to their questions. And I owe them thanks for asking—for letting me know that something was missing in the story and in the theory about it. I hope that readers familiar with the first edition will find clarity gained and noth- ing essential lost in the edited version of the chapters that come before Chapter 8. I am grateful again to my clients, from whom I have learned how to put the new theory into practice. They have taught me that when they show up for real—in need of my personal, emotional presence—good things hap- pen if I, too, can show up for real, with the skill and care I owe them. I have learned with them that there need be no shame in any of the emotions between us, not even when it’s affection we feel. I can’t sign off on this second Preface without thanking those who always help me with my writing. My wordsmith daughter Adriel Weaver came up with good catches in a final edit of Chapter 8. My partner Mary Greey per- sists in believing that I and all my projects are wonderful (in essence, if not constantly). Sometimes I’m shy about how much her delight matters, but luckily she hasn’t been shy to show up and show some emotion about the new chapter—in which she gets a cameo appearance, as well she should. Pat DeYoung Toronto September, 2014