Model 3 ~ The Contemporary Relational Perspective


by Martha Stark, MD / Faculty, Harvard Medical School


As Irwin Hoffman (2001) has suggested, if the therapist is aware of feeling conflicted in relation to the patient, she may choose to share the fact of this conflictedness with the patient – “I want to tell you that 'x,' but I am afraid that 'y.'”


Here the therapist is expressing aloud the conflict with which she is struggling – a conflict that might well be reflective of the patient’s own internal state of dividedness. “I am tempted to give you the advice for which you are looking, but my fear is that were I to do so, I would be robbing you of the impetus to find your own answers.”


“I find myself feeling angry with you for being so often late and wanting you to understand how it impacts me. But then it occurs to me that it might be more important for us to try to understand what you might be trying to communicate to me by way of your frequent lateness.”


“I am tempted to respond to your request by saying that of course you can borrow one of the magazines in my waiting room, but I am also realizing that were I simply to say ‘OK,’ we might lose an opportunity to understand something more about you and, perhaps, about us.”


To a patient who says she wants the therapist’s approval regarding her decision to terminate – a termination that the therapist thinks is premature: “I am tempted simply to offer you the approval you are seeking. It is, after all, important that you do what feels right for you. But I am also aware of feeling, within myself, that the time is too soon and that were I to support your decision to leave, I might ultimately be doing you a disservice.”


Hoffman, I. (2001). Ritual and spontaneity in the psychoanalytic process. Abingdon-on-Thames, UK: Routledge / Taylor & Francis.