The Therapeutic Stance
There are many modalities of person-to-person interaction. Human beings can fight, feed, or play with each other. It is significant that one of the earliest references to another fundamental quality of many object relations appears in Genesis, 2:18; indeed, it is the first definition of a human relationship that is mentioned in the Bible. God creates woman as a helpmate of Adam. More exactly, in the Hebrew, Eve is a help meet for Adam—a match for him, or someone to be at his side. It is a long way from the Creation to the busy workings of an emergency room, but the concept of one person helping another as equal partners in a mutually congruent relationship has been honored in all ages. The idea is captured in the modern theoretical construct of the therapeutic alliance, which we might appropriately rename the helping alliance. It is compounded of that part of the person in need that seeks, however awkwardly or even defiantly, some form of assisting contact with another; and that part of the therapist that is the matured distillation of his experience, his practical and theoretical knowledge, and those sublimations that have led him to his profession. This more or less rational aspect of the therapist’s share in the helping relationship can be usefully designated as the counteralliance, much as the term countertransference is applied to that counterpart transference of the therapist that is analogous to the mostly irrational transference of the patient.
KeywordsTherapeutic Alliance Crisis Situation Soft Neurologic Sign Psychiatric Emergency Room Emergency Room Patient
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