Connecting with Compassion: The Therapeutic Relationship

Abstract

Compassionate connection is the heart of narrative psychiatry. As humans, we live our lives in relationships. Who we are and what we feel—the very development of our nervous systems—arises through our connection and emotional resonance with others. The quality of that attunement determines what is possible for us to feel and to know of ourselves. The meanings we give our experiences and feelings—the stories we tell about who we are—arise in relationships. Every story has a teller and an audience, and the nature of that audience determines what kind of story it is possible to tell. Telling an emotionally moving story in a way that is healing requires an empathically attuned listener. For all these reasons, connecting with our patients is our first priority. Creating a therapeutic alliance with our patients begins with emotional attunement and is strengthened by transparency and collaboration. That is, in narrative psychiatry, we are open with our patients about our thought processes and we work with them in a side-by-side stance to look together at the problems they are facing, the values and strengths they can develop, and the treatment resources they can choose to draw upon. Addressing the impact on patients’ lives of racial, cultural, sexual, gender, and other identities and narratives with sensitivity to issues of privilege and oppression also builds trust. Attending thoughtfully to issues of power in the doctor-patient relationship serves to empower patients as partners in the treatment process. Supporting patients in developing empathic communities of support outside of therapy expands opportunities for healing connections in patients’ lives. Let’s look at how we can put these ideas into practice, starting with developing emotional attunement. Empathic emotional attunement is connection at its core, and from infancy on, experiencing another’s empathic attunement is soothing to us, body and soul. It is, in itself, healing. Becoming emotionally attuned with someone means listening with your whole being. It is attending not only to what you see and hear, but also what you feel in your gut and in your heart in being with the other person, and responding compassionately from that place.