Psychotherapists’ experience of power in the psychotherapy relationship

This research study investigated how psychotherapists experience power in the psychotherapy relationship. The intention of the research was to provide a rich description as to how power shapes, informs and presents itself in the psychotherapy relationship. I have used phenomenology as a philosophy and methodology in undertaking this research, drawing upon Giorgi’s (1989) and Wertz’s (2005) adaptation of the phenomenological method for psychological research. In total, nine experienced integrative psychotherapists, working in private practice, participated in an in-depth open – ended interview about their experience of power in the psychotherapy relationship. Each interview explored their experience with two clients with whom they were currently working and with whom they had been working for over six months. I identified four subordinate themes from across my participants’ accounts. These were: the therapist’s experience of both the client’s and their role power, power as a dynamic and emerging relational and social process, different forms of power dynamics in the psychotherapy relationship and the therapist’s ambivalent feelings of power. The findings highlight that power is experienced as being an inescapable phenomenon of the psychotherapy relationship, complex, constantly shifting and, at times, paradoxical. For much of the time, the power dynamic is pre-reflective and largely out of conscious awareness. Therapists experienced power to be implicit to the structure of the psychotherapy relationship and the therapeutic context. The power dynamic of the therapeutic relationship is established in the opening interactions of the therapy. This usually involves the therapist being constructed by the client as the powerful figure in the relationship. As the work continues the form of the dynamic reconfigures into different forms. These include power struggles, the client experiencing the therapist as the ‘abuser’, the therapist experiencing powerlessness or a relationship of shared power. Participants’ accounts indicate that their subjective experience of both their and the client’s vulnerability, the mutual construction of their respective social identities and status and the wider social relations of the profession of psychotherapy all influence the power dynamic of the psychotherapy relationship. This research study highlights the importance of power in the practice of psychotherapy. It demonstrated the need for the therapist to tolerate the client’s need to construct them as a figure of power, to be dependent upon them and to express their anger, hate, rage and envy of their power. Participants’ accounts revealed that the exploration and re-negotiation of the form of the power relationship between therapist and client is pivotal to the process of therapeutic change for specific clients. Therapists described how this facilitated the establishment a collaborative relationship in which power was shared between them and the client. Therapists reported that such as re-configuration of the power dynamic facilitated the client experimenting with their power in the therapeutic relationships and their relationships with others. What is evident from the findings from this study is that the phenomenon of power is central to the therapeutic relationship. It suggests that practitioners can enhance their practice by observing, exploring and negotiating the power dynamic of their relationship with their clients. Power in the therapeutic relationship therefore needs to enter the mainstream discourse and debate in the counselling psychology and psychotherapy communities.

Doctorate in Counselling Psychology and Psychotherapy by Professional Studies (DCPsych)