Mental health professionals spend years researching and learning a variety of psychotherapeutic techniques and methods in order to help patients move from distress to flourishing. However, research has time and again indicated that the most curative factor within therapy is the strength and quality of the relationship between the therapist and the patient. While technique and experience do matter within therapy, a patient’s relationship with his therapist has been shown as the most important element of therapy.
[Catholics] can offer our understanding of relationships as a communio personarum.
What does this finding tell us? For one, it informs mental health professionals that the most important tool within therapy is ourselves. Thus, we should spend time working on curing our psychological blind spots and achieving peace within ourselves if we are to help bring others to peace. The old adage of you cannot give what you do not have rings true in this case. Additionally, it shows that no matter what a person is going through (be it depression, anxiety, or a personality disorder), our humanness is what makes us able to comprehend each other, and is what we desire from each other. By offering our humanness to our patients we can look in their eyes and say, ‘Even though I can never fully understand you nor what you are going through, I as a fellow human being will sit with you through your suffering so that you do not have to go through this alone.’ Time and again, my patients have told me that it was the feeling that they were no longer alone helped them the most in their suffering.
What can Catholic anthropology offer this research finding? Simply put, we can offer our understanding of relationships as a communio personarum or “communion of persons.” Such an outlook transforms the therapeutic relationship, along with therapy in general, from a purely professional one where I only care about reducing your symptoms, to a professional relationship where I see you as a fellow child of God who needs a helping hand in reaching your telos. Namely, your salvation and flourishing within your vocation. I also now see my job as therapist as a vocation since how I guide the patient has both temporal and eternal ramifications.
The Therapeutic Alliance within Therapy: An Abbreviated History
Whenever I answer the question of what I do, the questioner often asks if therapists still have people lie down on a couch while talking. While such practices are now rare, they do point to a time where therapists seemed to almost be afraid of patients. This practice was defended by arguing that it allowed the patient to freely associate and allowed the therapist to remain the objective analyst. The therapist was also to remain completely neutral and give no sign of who he was outside of therapy (e.g., no wedding rings, no family pictures, and to never disclose any personal information). While this therapeutic format does have some merit, it ultimately denies the human aspect of therapy. Indeed, the therapist intentionally avoids connecting with the patient in a real way. Everything is prim and proper, and any hint of deviation fromIn response therapist Harry Stack Sullivan pioneered a format of therapy known as interpersonal therapy. Within it, the therapist seeks to become a participant-observer within the therapeutic process. Thus, Sullivan sought to move back and forth between expert and fellow wayfarer with the patient. Presently, nearly all schools of psychotherapy have come to understand the importance of the relationship between therapist and patient, but they all lack a grounding in a proper understanding of the purpose of this relationship along with the ultimate end of the patient’s life.
One underlying theory that has permeated modern psychotherapy’s understanding of the therapeutic relationship is that man’s telos is self-actualization. Some therapists believe that human flourishing is a completely subjective notion, and thus whatever the patient desires (e.g. leaving their wife, cheating on a test, or stealing because they feel oppressed) is what the therapist should support. Such a theory focuses the person inward and diminishes their capacity to grow in virtue and the spiritual life. Like many aspects of modern psychotherapy, therapists have developed the beginnings of a good theory, but since they lack the proper philosophical and theological underpinnings, their theory is built on sand and collapses when put to the test of reality.
The Second Vatican Council’s document Gaudium et Spes stated, “Man, who is the only creature on earth which God willed for itself, cannot fully find himself except through the sincere giving of himself” (n. 24). The late Holy Father, St. John Paul II, a Council Father himself, built upon this idea to develop the notion of interpersonal relationships as a communio personarum. In essence, communio personarum is two human persons guiding each other towards flourishing, and experiencing that they themselves are uniquely human. They explore such existential issues of death, feelings of isolation, free will and responsibility, and finding meaning in their individual lives. Communio personarum also predicates the unpopular anthropological fact that man (male and female) is fundamentally different from any other species in creation. We are not equal to animals, we are above them and we must act accordingly. No longer can we argue that man finds fulfillment giving into his base desires, nor can he find fulfillment in ignoring his innate desire for a monogamous relationship. By enlisting communio personarum, the therapist anchors himself within the realm of proper anthropological reasoning, and as such protects both himself and his patient from deviating from the path God has set out for their relationship. The Catholic therapist keeps his patient on such a path, though, gently and always respecting his free will. In this way, the therapist always helps the patient to move both towards his vocation and his flourishing in this life.
A Catholic View of Therapy
Having a proper understanding of the relationship between the therapist and patient leads to the logical conclusion of how the Catholic therapist views therapy. Therapy is an encounter between two human beings where one (the therapist) lends his expertise to the other (the patient) in such a way that helps the other examine his life up to this point, and then through their relationship the therapist helps to guide the patient to a better understanding of himself and his relationships so that the patient can better fulfill his vocation. Granted, the therapist needs to use a variety of techniques to help the patient cope with such symptoms as the patient’s anxiety or depression, but in order to effect a substantial change the therapist and patient need to dive deep into the patient’s very self so that the patient can give of self.
The therapist anchors himself within the realm of proper anthropological reasoning, and as such protects both himself and his patient from deviating from the path God has set out for their relationship.
Therapy also becomes life in miniature for the patient. Within it he learns (and/or relearns) how to disagree without being disagreeable, that his emotions and cognitions will not overtake him and are acceptable, and that he has a purpose within this life. Helping the patient find individual meaning is one of the main aspects that sets the Catholic therapist apart. We already know our ‘abstract meaning’ (i.e. to know, love, and serve God in this world so we can be with Him in the next), but that does not mean that we are able to assign meaning to certain events within our lives as they happen. By employing communio personarum, the Catholic therapist is able to help the patient explore possible meanings while still remaining grounded. In all, therapy is more than symptom reduction and allows the patient to focus beyond himself. It is a great adventure where we learn how to better others, make peace with our past, discover God’s plan for us through events in our lives, and thus to be better able to serve Him in this world so that we can be with Him in the next.