Stage 7: Generalizing the Therapeutic Relationship

Once patients accept their maladaptive relational pattern via confrontation, therapy enters a new stage, based on open and honest communication. Initially, the therapist models open and honest communication by sharing what it felt like while the patient tried to induce the him or her into the maladaptive relational pattern. When patients hear how therapists experience their manipulations, they begin to understand how they have affected others.

Patients explore relationships with family members, friends, and coworkers from this new perspective, generalizing what they learned in therapy to other relationships. Patients begin to make conscious efforts to change their relationships through more honest and less manipulative interactions. Cognitive-behavioral techniques such as assertive communication and cognitive restructuring are helpful in this process. Efforts at changing can also be facilitated by having patients enter group or family therapy at this time.

Stage 7 continues until patients have resolved their manipulative and conflicted methods of relating. Their central realization is that they are more likely to be accepted and less likely to be rejected if they are honest about whom they are than if they distort themselves to gain acceptance. Patients learn that relationships involve taking risks and that rejection may occur. But, once the self has strengthened through internalizing positive objects (the patient-therapist relationship is a positive object), fear of rejection lessens as the patient learns self-acceptance and self-nurturance.



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