June Book of the Month
By Marnie McGann
Transformational Relationships by Dan Short explores creating stable, supportive, nurturing, empathetic relationships in a therapeutic environment. In the first sentence of the preface, Short provides his reasons for writing this book: “Having witnessed up close the destructive power of unhealthy relationships, I grew up wondering, ‘What do you do so that others are better off for having known you?’” And throughout the book, he answers this question, diving deeply into the heart and soul of psychotherapy.
Therapy as a Dynamic Force
The premise of the book is that therapy is not just a relationship between the therapist and client; it is a dynamic force that impacts the development of both client and therapist. A transformational relationship is built on trust, empathy, understanding, and the willingness to be vulnerable. It is about deep emotional connection and intentional rapport.
Short credits Milton Erickson for forging the way with flexible, collaborative, dynamic relationships that are strategically tailored to the client’s needs and goals. He writes: “…the appropriate response for a given situation is not found in the pages of a technical manual or in the mind of the therapist, but rather it resides in the ever-evolving relationship context.” He goes on to say that he does not subscribe to any one model of therapy but instead relies on his experience and whatever seems to work in the moment, approaching each client with a curious mind, unhindered by protocols, academic theories of change, and therapeutic doctrine. “The reductionist nature of mechanistic models of change impede interpersonal understandings,” he explains.
The book is divided into two parts that complement each other. The first part presents the Principles of Compatibility, which include verification, affect attunement, reciprocity, attachment, and structure. Part II is the Standards of Therapeutic Relating. Because Short includes extensive footnotes (with citations that back up much of what he says), he suggests that the reader read the text only the first time and then read both the text and the footnotes the second time around. I found this to be helpful so as not to get distracted from the book’s overall flow and message.
What I love about this book is that Short includes many personal case examples and anecdotes, making the theories and principles he presents relatable and applicable. Rather than focusing on dogma, he encourages therapists to explore the landscape of relationships to stimulate personal evolution and growth that will ultimately lead to positive transformation.
Relationships are the context of our lives. We are born into them, and we must navigate them until we are no longer alive. Relationships are where behavior primarily occurs. But understanding, predicting, and navigating someone’s behavior can be tricky. Short has made it his life’s work to examine all aspects of the therapeutic relationship, even the nuances and subtleties, to provide each client with a tailored approach. “This shift in emphasis,” he says, “from the mastery of replicated techniques to an increased awareness of interpersonal dynamics, cultivates the type of spontaneity and flexibility needed for vibrant relationships with a variety of clients.” Improving the therapeutic relationship depends on the therapist being able to understand the client and tailor the therapy to each client.
Tailoring and Relationship Negotiation
Skillful assessment is crucial for a tailored approach, Short says. The therapist must truly get to know the client; their hopes, fears, goals, sources of energy, and what brought them to therapy. The therapist must have an intimate understanding of the client’s subjective realties—their memories, experiences, and beliefs.
Relationship negotiation in therapy is an ongoing, covert process. We all know that first impressions are important, and likewise, the initial therapy session can determine if there is rapport and a high level of complementarity between therapist and client. Verification in therapy is crucial for the client to feel as though they belong; that they are valued and understood; that the therapy environment is safe and supportive. But verification does not always mean that the therapist and client agree. In fact, disagreement might be a component of verification. Short writes: “Often it is necessary to confront clients for some part of their thinking and behavior while simultaneously affirming core aspects of their identity.”
In the therapeutic relationship, how a client perceives something takes precedence over reality. Short writes: “…subjective perception seems to play a more important role than objective fact during the formation of a relationship.” But he points out that verification is not a “deceptive strategy” aimed at making a client project an “idealized” or “flawed” self. Rather it is a dynamic process that serves as a starting point for relationships. He warns against shattering a client’s core self-concept because it is the “nucleus for an entire web of beliefs.” A transformational relationship should involve treatment goals that reflect the client’s subjective desires.
And throughout the book Short emphasizes the importance of understanding and honoring the client’s subjective realities and their perceived needs. In Part II of the book, he writes: “…therapists wishing to establish a supportive relationship do not seek to indoctrinate, seduce, or manipulate the client. Instead, there is a profound respect for the subjective realities operating within the client’s mental world.”
Principles of Compatibility
Affect attunement is the emotional connectedness of the therapist and client. Reciprocity, Short says, is an example of horizontal complementarity. It is the process of mutual self-disclosure that strengthens the relationship bond and helps the client feel accepted and understood. Both therapist and client must be willing to be vulnerable and willing to share their thoughts. A therapist’s vulnerability and self-disclosure can deepen the trust a client has with the therapist, as the client perceives the therapist to be more human and honest. Short offers examples of how he has been open with clients without oversharing or overshadowing the client and his or her own experiences.
Social science has discovered that a secure attachment is necessary for us to thrive at work, in our families, and in the world at large. Understanding a client’s attachment style (anxious, avoidant, etc.) can help a therapist bond with a client. Short maintains that capable therapists should not only have knowledge of technique but an “emotional readiness to relate from a position of secure attachment.” And because the therapeutic relationship is dynamic and ever changing, Short says that therapists need to continually reassess the relationship so that secure attachment remains. And the good news is that it is relatively easy to develop a secure attachment even with the most damaged clients. Short has used Erickson’s method of letting the client know that they can take his voice with them to draw upon as a resource and that his voice can morph into the voices of others who the client perceives to have wisdom and strength and eventually that voice will become their own internal guide.
The nature of psychotherapy is that the therapist is in the dominant position. However, since therapy is an ever-changing dynamic, switching from dominant to submissive is often required of a therapist, especially if the client is resistant or might regret disclosures. Carl Rogers demonstrated that it is not always in the best interest of the client for the therapist to be dominant. Short offers excellent personal examples of how he has assumed the one-down position for a better therapeutic outcome.
Standards of Therapeutic Relating
In Part II of the book, Short discusses the standards in therapeutic relating. It comes down to one thing, Short says, the client’s psychological well-being. His three relational objectives associated with a transformational event are: 1) an increase in self-awareness and self-trust; 2) a positive self-concept; and 3) movement toward autonomy away from over dependence. “Skillful therapists,” Short writes, “spend more time discovering what is right about a client than finding flaws…The new terminology is important because it suggests the presence of strength rather than helplessness. The use of labels that carry more positive implications is not a technique that belongs to one type of therapy, but rather a principle that should be applied to all helping relationships.”
Shorts maintains that therapists take time to celebrate the client’s accomplishments. And he champions in-person therapy from a “live caregiver” rather than self-help books and computer programs. And when a client does share good news of taking a step in the right direction or making a change, the therapist should physically express their joy with the client’s progress by a smiling, shaking the client’s hand, or giving two thumbs up, etc.
Framing a Transformational Relationship
In Chapter 8, the final chapter, Short describes how transformational relationships are different from supportive relationship. In our families, marriages, and friendships we may have ongoing supportive relationships that we cherish for their duration. But in a therapeutic, transformational relationship, the final chapter must be that the therapy ends, where the care seeker no longer needs the support of the therapist. Autonomy and personal agency are the goal, and therapy, Short says, should be framed in this way. It is important that the therapist understands what the client envisions as the timeline for the therapy. “A good contract,” Short writes, “provides structure and flexibility.” Questions a therapist might ask a client initially could be: “How long do you think this should take,” and “How often do you need to see me?” Therapy, Short says, is a collaborative effort with a mutually rewarding experience as the outcome. Therefore, involving the client in the logistics of the therapy makes sense. “Because it is the client’s formal declaration of choice, either by words or actions,” that tends to guide future behavior, the process of soliciting a formal commitment can determine the course of the relationship. In therapy, commitment is used to activate the power of will toward purposeful, goal-oriented behavior.” And as therapy progresses, it should be more about thought provoking questions rather than information or advice.
Transformational Relationships is a practical, insightful, inspiring book that can help therapists from all schools of thought improve their practice by building stronger therapeutic alliances. Written from the heart, this book delves deeply into all aspects of therapy, guiding therapists in providing more thoughtful, caring, tailored therapy for clients’ well-being.
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