What’s Love got to do with it? By Phillip Ellington

How do psychosynthesis therapists conceptualise and work with situations where they can’t find love for a client? Advanced Diploma graduate Phillip Ellington explores this question in his dissertation.

 

What’s love got to do with it?

A qualitative study

“What is most meaningful often cannot be measured. What is verifiable may not necessarily be what is most important. As the British scientist Denis Burkitt once wrote, “Not everything that counts can be counted.” (Ornish, 1998)

 

Abstract

This dissertation explores how experienced psychosynthesis therapists understand and work with situations where they can’t find love for a client. It was prompted by my own experience of an extremely visceral response to a particular client and the fact that I found little in the literature to help me frame my experience. It examines this question in relation to Firman and Gila’s (2010) position on psychosynthesis as a “psychotherapy of love” and in terms of the well-established understanding that the relationship between therapist and client is the major determinant of therapeutic outcomes (Fluckiger, et al., 2012). In support of this enquiry, I explore my participants’ positions in relation to love and how they experience love as an active principle within their own practices. 

What emerged during the course of this study was a distinction between adverse intrapsychic projections (negative counter-transference) and the effect of difference on the autonomic nervous system in the therapeutic dyad. The findings offer new insights into the factors that influence adverse responses to clients and the limitations of the counter-transference model. Findings underpin the powerful role played by the concept of bifocal vision (Whitmore, 1991, p. 62) in holding a transpersonal frame around the adverse experiences. This research includes an underpinning literature review and in-depth interviews with four participants using Interpretative Phenomenological Analysis (IPA) to derive a set of themes from which conclusions and recommendations have been drawn: 

 

Conclusions and recommendations:

•A lack of clarity in the way love is defined within psychosynthesis may constitute a problem for themodality’s theoretical base. The theoretical position that love is essential, highlights a gap between theory and praxis. 

 

Recommendations

1. a.Psychosynthesis training could include a more comprehensive exploration of love.
2. b.A CPD module for qualified practitioners. See brief proposal in appendix 5.

•Love is essential, and may emerge over time, within a co-created process, and it may not.

 

Recommendations

1. Research seeking greater clarity around the terms used to describe variants of counter-transference: negative, traumatic, autonomic, etc.

1. A re-examination of the psychosynthesis theoretical position on the essentialness of love
2. Further research into the psychosynthesis concept of altruistic love compared andcontrasted with unconditional positive regard.

•Bifocal vision and disidentification mitigate adverse responses to clients.

 

Recommendations

1. Psychosynthesis training could include aspects of working with dislike for clients.

•The transference, counter-transference model doesn’t recognise autonomic system responses.

 

Recommendations 

1. Further research into the relationship of the disgust response to counter-transference theory, attachment theory, relational dynamics, intersectionality etc.
2. Training focus on the autonomic nervous system and advances in neurobiology.
   

 

Chapter 1 Introduction 

This section describes the evolution of the research question and defines the concepts I’ll be using throughout. In light of recent studies of unconscious bias in research (Yager, et al., 2021), I’ll also describe my opening position on some of the key concepts that underpin this study. 

 

Opening positions

I came to this study believing that unconditional love, or ‘agapé’, is such an essential aspect of psychosynthesis psychotherapy that no skill or technique could compensate for its absence. I also assumed that I’d find a similar orientation amongst my study participants and didn’t. This personal belief, along with other assumptions I make, preconfigure my approach to examining the research question. For that reason, I will begin by disclosing my own stance on some of the key concepts that underpin this research. 

 

On the transpersonal-spiritual 

In my mid-twenties, a moment of despair triggered what Maslow describes as a “peak experience” (2011, p. 194). I had a tangible sense of being plugged into the energy of universal love. Everything living, including myself, was connected by a subtle geometry. The experience convinced me that the transpersonal, defined by Shorrock as “where consciousness extends beyond (trans) the individual or personal” (2008, p. 8), is not a realm apart, but is, as Assagioli writes, “the essential unity of human nature beneath and despite of, all individual and group diversities” (1973, p. 89). Science seems to offer evidence for that ‘unity’. Theoretical physicist Bohm, for instance, describes existence as “an unbroken whole” (1980, p. 218). Ecologist Muir writes, “when we try to pick out anything by itself, we find it hitched to everything else in the universe.” (1911, p. 110). I believe the rational and the spiritual, which are both important to me, are not mutually exclusive. For instance, I accept the evolutionary biologists’ view that our propensity for religious experience is an evolutionary adaptation for extended social bonding (Wade, 2009). But I also choose to believe that our longing for the spiritual springs from something greater than survival contingency. Finding this “both… and” (Whitmore, 1991, p. 62) position in the way psychosynthesis holds both the transpersonal and the rational/scientific, is what originally drew me to the practice. 

 

On psychosynthesis 

For me, psychosynthesis represents a personal and transpersonal development path that addresses the balance of spiritual and material wellbeing. These two dimensions of growth, conceptualised as “transcendence-immanence” (Firman & Gila, 1997, p. 52), describe how we are both enmeshed in experience (immanent) and separate from it (transcendent). The same two dimensions are concretised in the psychosynthesis practice of “bifocal vision” (Whitmore, 1991, p. 62), seeing the other as a unique soul, redolent with meaning and potential (transcendent), calling to the personality for expression (immanent). Inherent to this position is the concept of soul; a ‘higher Self’, “above and unaffected by the flow of the mind-stream” (Assagioli, 2000, p. 19). I believe it is the call of this ‘higher Self’, that Aristophanes is referring to as our “longing for wholeness” (Benerdete, 1986, p. 107). 

I first took the Psychosynthesis Trusts’s foundation course in 2003. Having roamed awhile on the outer fringes of the airy-fairy, the course provided a bridge between the ineffable-spiritual and the rational-intellectual. I took the course again in 2018, qualifying as a counsellor in 2021. My practice since then, might be described as ‘love oriented’. 

 

On love 

I share the widespread belief that common psychological problems arise from an absence of love in childhood. I also believe that, irrespective of theoretical approach, skill or technique, it is the unconditional love, or agapé, the counsellor brings to the therapeutic relationship that effects healing. 

Like all emotions, love has an objective physiological embodiment as well as subjective psychological and behavioural aspects (Plutchik, 2001). Love is a neural technology with distinct loci of activation in the brain which enable neurobiologists to distinguish romantic from maternal love (Esch & Stefano, 2005) (Zeki, 2007). Some researchers also claim to have identified the neural basis for unconditional love (Beauregard, et al., 2009). Like all emotions, the physiological effects of love are regulated by the limbic system and expressed in the body as involuntary sensations. Romantic and maternal love produce distinct physiological effects and I believe this is also true of unconditional love. I, for instance, experience a subtle sense of skin thickening and an odd corona at the periphery of my vision. There’s also a perceptual shift into something less cognitive, more relaxed, like the difference between driving in town and long-haul motorway driving. When something unexpected happens, there’s an instant switch back to cognitive mode. I feel this switching of perceptual modes as the fluxing of the elements of love and will in my own psyche; the embodiment of bifocal vision. 

 

Evolution of the research question 

Knowing I wanted to study love was one thing. Finding focus on such a vast subject was another. Until an extremely unsettling event in my clinical practice provided it. Towards the end of an otherwise unremarkable session, a middle-aged client began a diatribe against the Jews. Dismissing the historical scale of the Holocaust, he remarked, “they brought it on themselves”. 

Nothing had prepared me for the physical impact of this man’s opinions. My own Jewish father had survived the Holocaust and, despite the prime directive to do no harm, I fantasised about disclosing this. I wanted to shame him; to hurt him. My supervisor saw it as a personal growth opportunity. Referencing bifocal vision he suggested that while I couldn’t find love for the man, perhaps I might for the wounded child within. His advice wasn’t wrong. But it missed the sheer intensity of my reaction. I wondered if he’d have offered the same suggestion if I’d been a black therapist facing an openly racist client. I did find some accommodation in the thought that we’d both been shaped, in part, by the same world events. (As Fee notes, personal biographies always locate within a wider cultural context (2020)). But ‘accommodation’ falls far short of the love I believed essential to therapeutic healing. As I looked forward with dread to our next session, I realised I had in, the ugly, but precise idiom of TV’s Love Island, ‘got the ick’; the apprehension of disgust. Finding little in the literature and assuming other psychosynthesis therapists had met something similar, my research question became: 

 

How do psychosynthesis therapists conceptualise and work with situations where they can’t find love for a client? 

Refining the research question 

Before describing the literature review, I will add some further notes to some of the concepts which frame this study. 

 

Disgust 

Getting the ‘ick’ refers to a sudden feeling of revulsion or disgust, usually around someone of romantic interest. Believed to be unique to humans, disgust is an “emergency emotion” (Plutchik, 2001, p. 27), triggered by perceived existential threat. It likely evolved to help us resist our main predator, “pathogens” (Herz, 2012, p. 157). The disgust I felt towards my client left me feeling shamed and professionally compromised. It also presented an ethical dilemma; how might I balance the harm caused by continuing to work, unable to love him, against the harm potential in referring him to another therapist. Perhaps another clinician, one without my particular background, would be better suited to work with my client, but in the referral, must I, in due diligence, explain the reasons for the transfer? And should I explain to the client honestly and risk the impact of that directness? Or do I excuse myself with some white lie of going away, or having too full a case load? 

 

Counter-transference 

Difficulties translating ‘unable to love’ into online search terms, helped me realise how the language framing my question was limiting my understanding. I’d missed that my question actually touched on counter-transference. I’m apparently not alone in this blind spot; a recent study of psychodynamic psychotherapists identifies a general inability to identify adverse feelings about a client as negative counter-transference rather than as personal and professional failings (Linn-Walton & Pardasani, 2014). This posed a question. What in the way we conceptualise counter-transference might produce such a blind spot? I will hold this question in mind through the literature review. 

 

Self-care 

I generally take a fairly robust approach to self-care. I agree with Millichamp that, “Intimacy requires an equal amount of risk-taking” (2018, p. 9). But this client polluted my thoughts, my sleep, even my morning swim in a way I’d not experienced before. I took it to therapy and I used Ngalso, a Tibetan Buddhist self-healing meditation, to expel the dirty smoke of him. But still, he persisted. So, I was curious about my participants’ self-care and imagined this to be an important aspect of the study. 

 

The language of love 

Psychology’s pretensions to science are evident in the borrowing of medicalised terminology, glossy with “the objectivity of the medical model” (Givens, 2015, p. 12). In this context, ‘love’ appears hopelessly unscientific. Which perhaps explains the professional diffidence around its use. As BACP’s Keys writes online, “Love is hard to talk about openly in a professional context without feeling embarrassed” (2017). Some therapists prefer the more scientific sounding “unconditional positive regard” (Rogers, 1961, p. 64), from person-centred therapy. Study participants may have other words and ways of defining love in their praxis. This suggests my research interviews begin by exploring participants’ positions on love and the language they use to describe it. 

 

Defining love 

I haven’t found Assagioli’s thinking on love clear enough to provide a suitable definition for this key concept in my study. He writes of love in broad terms like ‘altruistic’, ‘romantic’, ‘sentimental’ and ‘impersonal’ (1973), which, without the clarity that Plato’s forms provide, leave me guessing about his position. Plato defined a number of forms of love with different characteristics. Eros is born of the hunger for completeness that Aristophanes spoke of; the passionate desire to possess whatever is deemed desirable. In the sense that it judges merit in the other, it is acquisitive and essentially self-serving (Liddell, et al., 1996) (Nygren, 1953). A higher form of unconditional, non-acquisitive love is Plato’s agapé. While eros conceives of and pursues perfection, agapé is “neither kindled by the attractiveness nor quenched by the unattractiveness of its object” (Nygren, 1953, p. ix). Agapé would become the ideal of selfless, detached, beneficent love that influenced medieval chivalry, the courtly love of the high middle-ages, the romanticism of the 19th century (Rougemont, 1983) and humanistic psychology in the 20th century. 

I find the essence of agapé in a working definition of love borrowed from artist Anne Truitt, “the honouring of others in a way that grants them the grace of their own autonomy.” (2013, p. 70). 

 

Ontological position 

Amongst my participants I expect a variety of views. Having stated my own views and their potential impact on this research, I remain open to results that diverge from these positions. This is in keeping with a constructivist ontological position which acknowledges that there is no one truth, but many. And with an interpretivist epistemological position which brings together different perspectives in search of an overall understanding rather than a single truth. Findings will rest on my participants’ interpretation of their experience; their hermeneutic enquiry, and on my interpretation of their interpretation; my hermeneutic enquiry. In that sense this study is a product of a double hermeneutic process. (Jupp, 2006). 

 

Chapter 2 Literature Review 

In this section, I’ll explore how love as an aspect of therapeutic endeavour has been conceptualised and represented in psychosynthesis and wider literature. 

 

Love in a clinical climate 

In the early 20th century, Freud’s psychoanalysis led the market for psychological theorising. Freud viewed human nature as fundamentally dominated by instinctual urges. At base is the ruthless id, hungry for pleasure and averse to pain; the pleasure principle (Freud, 1961). Only the socialising energies of the ego and superego, hold the id in check sufficiently for us to behave in a ‘civilised’ manner; the reality principle. This suppression preserves the social self from opprobrium, exile and ultimately “loss of love” (Kli, 2018, p. 75) and as a by-product causes neurosis (Freud, 1961). 

As Smail (1996) argues, had psychoanalysis been accepted as science, or proven to work, it might have remained the market leader even after Freud’s students launched rival theories of their own. As it was, Freud’s originality seeded three broad approaches to psychotherapy: psychodynamic (of which psychoanalysis is a subset), cognitive-behavioural and humanistic. Their respective theories of human nature would determine how they each would recognise and handle situations where love can’t be found. 

 

The psychodynamic approach to love 

The tensions engendered by the suppression of the id’s urges produces neurosis. Freud believed that by bringing these sources of tension into consciousness, they might be analysed, tensions would be released and neuroses resolved. For this process, the therapist invites the client to re-enact their deepest motivations, ‘projected’, or ‘transferred’ onto themselves. Iterations of the theory of “transference” (Freud & Breuer, 2004, p. 265), remain central to the psychodynamic approach. 

 

The dynamics of transference 

Transference represents how the patients’1 

1 I have used the terms client and patient interchangeably. I have tried to choose whichever feels most in keeping with the speaker’s own context and time period. feelings towards significant people in their past are unconsciously associated with people in the present (the analyst) (Freud & Breuer, 2004). Freud distinguishes ‘positive’ from ‘negative’ transference; affectionate feelings towards the therapist from hostile feelings (1912). He conceived of both as resistance to therapy, Freud thought that by working with the resistance, he could reach whatever it was that was being resisted. By consciously collaborating in the creation of the transference, the “analyst allows old wounds to be unearthed, relived and resolved” (Racker, 1968, p. 15). 

Although in an early letter to Jung, Freud writes, “psychoanalysis is a cure through love” (Lear, 1990, p. 27), he replaced the word ‘love’ with a more ‘scientific’ term, ‘libido’ (Lothane, 1998). Libido combines “all those tendencies which we sum up as love” (Reik, 1957, p. 33), lumped together as derivatives of the sexual drive (Freud, 1962). Even maternal love was seen as the sublimation of the sexual urge (Reik, 1957). The word ‘love’ would not appear in the American Psychological Association’s Glossary of Psychoanalytic Terms until 1991 (Lothane, 1998). Rather sadly, at the end of his life, Freud confessed “We really know very little about love.” (Reik, 1957, p. 37). 

Freud’s student Ferenczi meanwhile, argued for love as clinical necessity, asserting that, “the physician’s love heals the patient” (Suttie, 1935, p. 212). Freud thought such a notion was potentially dangerous. It might ravel the therapist up in romantic attachment, compromise the analysis or colour the interpretation (Halmos, 1965). Analysts instead must adopt the “emotional coldness of a surgeon” (Freud, 1912b, p. 115). Attempts at clinical coldness clearly failed, because the term “counter-transference” (Freud, 1910, p. 144) emerged specifically to connote the impact patients have on the analyst. 

 

Classical vs totalist counter-transference 

In the classical view, counter-transference is the therapist’s unconscious response to the patient’s unresolved conflicts that need to be overcome for treatment to progress. Treatment focused on the interpretation of the patient’s transference (Fosshage, 2011). The analyst would “turn his own unconscious like a receptive organ towards the transmitting unconscious of the patient” (Freud, 1912b, p.115). The later totalist view, came to consider every aspect of the therapist’s experience aspotentially offering insight into the client’s process (Tansey & Burke, 1995). From the totalist position, a new sense of the analytic situation itself emerged, as “a relationship between two persons” (Ibid, p. 23). In this sense, the totalist views counter-transference as an interpersonal field, rather than solely the therapist’s intrapsychic experience. While the classicist sees counter-transference as an obstacle, the totalist sees it as a potentially useful tool. Jung’s contradictory statements illustrate both sides of this debate, describing counter-transference variously as “always a hindrance” (The Tavistock Lectures, 1977, p. 349) and a “priceless opportunity” (Jung, 1975, p. 17367). 

Once counter-transference was defined, negative and positive flavours followed. Dislike for a client was seen as a negative counter-transference, rather than a response to any disagreeable aspects of the client’s personality. (Alves de Oliveira & Vandenberghe, 2009) (Mitchell, 1988). 

Winnicott comments on the detrimental impact on treatment of disliking one’s clients, (1949), though it seems he can only ever imagine such a situation occurring with severely disturbed clients. Where the therapist does form a dislike and the client is not psychotic, he recommends the therapist to therapy (Alves de Oliveira & Vandenberghe, 2009). 

Kohut describes disliking clients as “empathic failures” (1977, p. 92). Though he writes that they are “frequently encountered”, he then says that they, “should not produce undue guilt in us.” (Ibid). For Kohut, interpretation was the main reparative agent and any empathic failure on the part of the analyst need not “concern the ideational content” (1977, p. 92). He defines two kinds of negative therapeutic reactions that happen when the subjective worlds of therapist and client clash. The first, “Intersubjective conjunctions” (Ibid), occur when the therapist feels they empathically share their client’s experience and inadvertently colludes in avoiding material which to their mind is already understood. And, “Intersubjective disjunctions” (Ibid) occur when the therapist imagines they share their client’s mental configurations, but are actually mistaken. Either error may adversely impact the therapeutic relationship, but that is of secondary importance to Kohut. In fact, he stresses the potential value of ruptures, maintaining that “psychological structure is laid down (a) via optimal frustrations and (b) in consequence of optimal frustrations” (Kohut, 1977, pp. 98-99). 

Klein, whose object relations theory emphasises the developmental impact of emotional attunement between infant and mother, encouraged awareness of the entire “transference situation” (1952, p. 437). She originated the concept of “projective identification” (1946, p. 8), elaborating Freud’s notion of psychological projection as a defence mechanism. In this process, feelings and thoughts unbearable to the patient are consciously or unconsciously displaced onto the analyst as a ‘what I can’t bear in myself, I see and hate in you’ kind of way. Perhaps in recognition of the intensity projective identification can have, she describes it as a projecting ‘into’ rather than ‘onto’ the analyst (1946, p. 8). This certainly matched my own experience and I did consider if projective identification had played a part in my situation. It didn’t seem to fit, though I was alerted by Waska’s comments that left unrecognised, projective identification can lead to an acting-out of the most intense counter-transference (Waska, 1999). Once recognised, the visceral feelings the client evokes might become a containing function for working through projective identification. It still didn’t seem to fit. 

 

Disclosure of counter-transference 

Ferenczi’s approach to disclosing negative counter-transference to the client was “to make the source of the disturbance in us fully conscious and discuss it with the patient” (Ferenczi, 1988, p. xix). He denounced the practice of analysts masking their distaste for a client with superficial friendliness as “professional hypocrisy” (Lothane, 1998, p. 12). Denial of the analyst’s true feelings, he thought, constituted a “trauma inflicted on the patient” (Ferenczi, 1988, p. xix). Ferenczi’s radical honesty is perhaps understandable at that time, when psychoanalysts were fewer on the ground and patients perhaps more enraptured and compliant with this new ‘science’. But it was in conflict with Freud’s conception of the therapist as a ‘blank screen’ for the projection of the client’s transference and remains controversial within psychodynamic theory. Heinmann, for instance, writes that “such honesty is more in the nature of a confession and a burden to the patient” (Tansey & Burke, 1995, p. 136). Winnicott advises that well-timed disclosure enables the therapist to discharge negative feelings in a controlled way “enabling me to tolerate the situation… without losing my temper and every now and again murdering him” (1949, p. 73). A general body of opinion formed around the tactical use of disclosure of negative counter-transference as promoting clarity and authenticity within the therapeutic dyad and as a way of challenging a client’s resistance. A more radical approach also emerged, which sees counter-transference disclosure as an everyday part of the therapists’ repertoire. Searles in particular, argues for an almost aggressive use of disclosure, writing of his willingness “to needle and infuriate the apathetic… patient into more overt relatedness” (Searles, 1965, pp. 25-26). Where he drew a line was around disclosing personal aspects of his own life outside of the therapeutic interaction. 

The psychosynthesis position also supports the counsellor emerging from anonymity to offer “authentic human relating” (Whitmore, 1991, p. 23). The proviso being, that such sharing be always in service of the client. This presents a challenge, since it is hard to know whether one’s feelings of say, irritation, reflect anything meaningful about the client, or stem from a missed breakfast. To have therapeutic value, any disclosure intervention must first make this differentiation. 

In my practice, I do disclose negative counter-transferential feelings, of the “I notice I’m feeling bored/frustrated/detached” variety. The intention is always to invite useful exploration of what is occurring between us. But, with the client who prompted this dissertation, I did not. Owning the visceral extremes of disgust is not something I could imagine doing. To say, “I notice I feel disgusted by you” seems to me as destructively final for a therapeutic alliance as for any other kind of interpersonal relationship. So, I concealed my true feelings behind the hypocritical mask Ferenczi denounced. And felt ashamed. 

 

The position on love in psychodynamics 

Despite an apparent allergy to the word itself, the evolution of the psychodynamic approach brought a general understanding of the developmental importance of love. Winnicott defined the ‘good enough’ mother (1960, p. 592), as one who sufficiently facilitates infant development. He even refers to psychosis as an absence of maternal love, or what he calls an “environmental deficiency” (Abram, 2021, p. 778). Sometimes, Winnicott argues, the therapist must be more ‘good enough’ mother than analyst. Patients with pre-oedipal issues; that is, issues from before they’d consciously separated from mother, “must be managed rather than analysed” (Winnicott, 1975, p. 279). It seems clear that what he means by “managed”, is loved. Loved as a mother might love, in repair of environmental deficiency. Winnicott advises this approach for patients with pre-oedipal issues, but as Guntrip notes, psychoneuroses “always reach back to the pre-oedipal.” (1961, p. 413). Psychodynamic theory began to combine the healing power of insight with the affective potential of mothering (management). The therapist becomes the reparative parent, offering love and understanding. Clinical benefit comes from the feeling of being loved and also, as Searles argues, from knowing that they “are capable of arousing such responses in the analyst” (1965, p. 291). And as Suttie notes, when the therapist inhibits their feelings of tenderness, they dash the client’s hope for the fulfilment of their affective needs (1935). 

Still, love itself, like all emotions, was seen in terms of unconscious phantasies, drives and impulses; the psyche’s ‘software’. When Bowlby described love as an evolutionary adaptation to social bonding and the infant-mother bond as an innate biological mechanism (1979) he focused attention more on the ‘hardware’ of the brain’s neural circuitry. This bears on my research question because besides love, Bowlby identified another evolutionary adaptation; the fear of strangers. He suggests that we are adapted to form “affectional bonds” (1979) most readily with those most like ourselves and less readily to strangers, on a sliding scale of otherness. Bowlby’s stranger danger points to the source of intersectional tensions that underpin all human encounters. Crucially for this study, it seems that difference alone might represent the kind of existential threat that triggers the autonomic fight, flight, freeze response and also it seems, the autonomic disgust response (Herz, 2012). This spoke directly to my own experience. I will discuss the disgust response in more detail a little later. 

 

The cognitive-behavioural approach to love 

Harlow’s experiments with rhesus monkeys (1958) proved the deleterious impact of maternal deprivation on infants. Infant monkeys prefer a cuddly surrogate mother to a metal milk dispenser. Harlow provided empirical support for Bowlby’s contention that maternal love is an innate biological need. To behaviourists, Harlow’s apparatus suggested a mechanical solution to post-natal care (Vicedo, 2009). They interpreted Harlow’s findings to mean that infant care could be “administered without the personal participation of any human being” (Halmos, 1965, p. 199). Casler advocated institutional child-care for all, imagining perhaps the liberation of women from the drudgery of child care (Ibid). 

Researchers in animal behaviour coming together with researchers into cognition had, by the mid 20th century, coalesced into a new approach to psychotherapy called, naturally cognitive-behavioural therapy. The cognitive-behavioural theory of human nature assumes that all human activity is determined by cognitive variables; by the way we interpret and use information (Lee, 1992). Watson’s manifesto states “The behaviourist, in his efforts to get a unitary scheme of animal response, recognizes no dividing line between man and brute” (1913). Tellingly, Watson also said, “mother love is a dangerous instrument.” (Blum, 2002, p. 37). Emotional, physiological and environmental factors are seen as peripheral to the real problem, the way people think. Issues like depression are less emotional disorders and more cognitive distortions. The cognitive-behavioural solution rests on problem-solving skills, which can be learned and applied to virtually any situation in a highly structured form of therapy that perhaps appeals to therapists of a more scientific bent. Instead of love, they might talk about, ‘the reciprocal inhibition of anxiety’ (Halmos, 1965, p. 71). This position is encapsulated by Skinner, who writes, “what is love except another name for the use of positive reinforcement?” (1974, p. 282). 

In general, cognitive-behavioural therapy pays little attention to transference and counter-transference (Prasko, et al., 2022). Treatments tend to be relatively brief and in theory, transference issues are seen as only likely to be problematic with more extreme presentations (Ibid). In less challenging situations, rupture repair is based on specific repair models which generally see ruptures as arising from the client rather than the therapist (Safran & Muran, 2000). 

Rupture detection and resolution are key metrics in cognitive-behavioural therapy’s evidence-base. Repair models are based on two types of rupture: ruptures of withdrawal, where clients become avoidant and ruptures of confrontation, where clients become aggressively critical (Gardner, et al., 2019, p. 162). Safran and Muran’s model does acknowledge that ruptures may be initiated by the therapist, but their manual only addresses repairs to client led ruptures (Safran & Muran, 2000, p. 164). An independent evaluative study of rupture repair strategies (Eubanks CF, 2018) was left unsure whether the repair techniques most often used by therapists were those empirically proven most effective or simply the ones that predominate in the manual. 

There is some commentary on the amelioration of hostile counter-transference in the treatment of serious personality disorders where, as Winnicott notes, presenting behaviours can be objectively dislikeable (p.16). Betan, et al (2005) describe how negative feelings towards the client can emerge as feelings of guilt, fear and a lack of boundaries around fees and timings. In mitigation they recommend supervision and psycho-education around the transference model. 

Interestingly, Prasko et al describe a clash of “cultural values” (2022, p. 4) as a potential source of hostile counter-transference, echoing Herz’s findings on disgust response triggers (2012). 

 

The humanistic approach to love 

Another major theoretical branching off of Freud’s theoretical base developed into the humanist school. While the psychodynamic branch continued thinking of the psychology of the individual in terms of intrapsychic drives, structures and mechanisms, the humanist school adopted an interpersonal view that saw behaviour in the light of human relatedness and the conflict between dependence and autonomy. Jung, Rank and Assagioli were also interested in fostering the emergence of human potential. Potential for what Maslow calls “self-actualisation” (1943, p. 370), energised the humanists, who conceived of love as both a reparative need and the source of personal meaning. Characteristic of this approach was a counselling relationship “that generates a platonic exchange of love akin to what the Greeks called agapé-love” (Schneider, et al., 2001, p. 383). May, founder of Existential Therapy, explores the dialectic between love and will, arguing that true personal power is only ever achieved through love (May, 1953). Fromm’s (1957) contention that life’s meaning is founded on agapaic love is also found in Frankl’s (2004) notion of love as the basic condition for meaningful existence. Rogers, founder of the Person-Centred approach, whose “unconditional positive regard” was inspired by agapé (1965, p. 47), also believes love to be essential to therapy (Ibid). And, in a 2014 address to the Society for Humanistic Psychology, Robbins asked rhetorically on what basis the claim that each person is entitled to dignity stands. The claim is self-evident, he argued, when we shift to a “stance of agapé love” (Robbins, 2014, p. 1). Humanistic modalities though, don’t always use the term love, or agapé, often preferring the more neutral, more ‘sciencey’ unconditional positive regard. 

 

Counter-transference vs relational dynamics 

Some flavours of humanistic psychotherapy dispense with the transference, counter-transference model altogether. Rogers, for instance, identifies the model as an expression of Freud’s fear of positive and negative feelings towards clients (1961) and are anyway, only likely to appear in “a small number of extreme cases” (1965, p. 199). Other branches of the modality, do still use the model. Existential therapy, for instance, views it as rooted in the immediacy of the client/therapist relational dynamic and essential to their process (Walters, 2009, p. 1). 

Relationship dynamics within the therapeutic alliance are central in humanistic therapy. Ruptures, or strains are frequent (Eubanks CF, 2018). Commentaries I found tended to focus on confrontation types of rupture. Perhaps this is because they are more clearly, sometimes dramatically, interpersonal. With withdrawal types of rupture, therapists are unsure whether they represent an interpersonal issue, or an intrapersonal defence. That is to say, whether something is happening between therapist and client, or just to the client. Commentaries also consistently polarise client as ‘rupturer’ and therapist as ‘resolver’, though therapists do report confrontations with clients leaving them feeling guilty, less ‘present’ and less competent (Ibid). 

My question, for this love-oriented branch of psychotherapy, remains the same. How do humanist therapists conceptualise and work with situations where they can’t find love for a client? I wonder if the relative clarity of the way they frame love as the facilitative core conditions of empathy, congruence and unconditional positive regard (Rogers, 1957), doesn’t make resolving the question easier than the more nebulous psychosynthesis concept of “altruistic love” (Assagioli, 1973, p. 98). 

 

The psychosynthesis approach to love 

Assagioli, founder of psychosynthesis, was influenced by Buber (1970) who argued that all meaningfulness in life is derived from relationships. According to Buber, we either meet the other as an ‘it’; an object we might use for our own purpose, or as a ‘thou’; a whole and meaningful person in their own right. In recognising the full humanity of others, we become fully human to ourselves. 

Buber was scathingly antithetical to Freud (Friedman, 1985). In the afterword of I and Thou, he asserts that while the psychoanalyst may with insight make some successful repair, the real work; the regeneration of an “atrophied personal centre”, can only be achieved when the therapist enters fully into a “person-to-person relationship” (1970, p. 179). Buber’s dialogic theory supported the humanistic gravitation away from the curative power of insight, towards the healing potential of the therapeutic alliance. 

Although psychosynthesis would position itself within the psychodynamic school, there are many humanistic tendencies within the theory, including the centrality of love. Firman and Gila are unembarrassed to call psychosynthesis a ‘psychotherapy of love’ (2010), and unequivocally place agapaic, or “altruistic” love (Ibid. p, 5) at the centre of psychosynthesis practice. They argue that the primary job of psychosynthesis therapists is “to love their clients in this altruistic, empathic way” (2010, p. 5). Without this, they claim, “healing and growth cannot occur” (ibid). This assertion goes to the heart of my question of how we handle situations where love can’t be found. For, if there were no expectation that love should be found, we’d hardly be concerned when it isn’t. That it ‘should be found’ suggests an extra burden attends on psychosynthesis therapists who can’t find love. Firman and Gila briefly discuss the impact of what they call “traumatic counter-transference” (1997, p. 241), arguing that a client’s trauma can activate the therapists’ own past experience of trauma and “plunge the therapist into a negative personality position” (Ibid). The implication is that the therapist is being destabilised by the client. In the most obvious way, this must be correct. Yet, as in my case, it may have little to do with the client’s trauma sometimes and more to do with the therapist’s own nervous system. 

 

Transpersonal counter-transference 

From transpersonal psychology emerged a distinct flavour of transference, called, naturally, ‘transpersonal transference.’ Transference had been viewed as the compulsive repetition of historical associations stored in the ‘unconscious mind’ (Freud, 1955), but the psychosynthesis model of the psyche posits two unconscious minds. Freud’s model of a single, monolithic lower unconscious is augmented with a qualitatively ‘higher unconscious’ that holds transpersonal energies and is the source of higher qualities such as altruistic love, creativity and spiritual illumination. In a transpersonal modality the therapist may be called to work with transferential projections from this higher unconscious. Psychosynthesis practitioners themselves may also evoke associations and projections of transpersonal or ‘spiritualised’ qualities the client consciously or unconsciously longs to embody; qualities like “love, compassion, inner peace and truth” (Whitmore, 1991, p. 101). Like energies from the lower unconscious, energies from the higher also meet resistance. Haronian describes this as a “repression of the sublime” (Haronian, 1972, p. 10). The call of our higher potential can be more threatening than inviting, Whitmore argues. It threatens the safety of the “survival personality” (Firman & Gila, 1997, p. 20); the collation of socialised bits of our whole selves that manage the dangerous business of getting through life. 

The psychosynthesis counter-transference model extends further still, to include the subtle influence of what Assagioli calls the “general psychic environment” (Assagioli, 1973, p. 17) and Jung calls the “collective unconscious” (Quinodoz, 2005, p. 74). 

This doesn’t mean there is a single unified psychosynthesis position on counter-transference. Assagioli, thought it need only be addressed if it presents an obstacle (Whitmore, 1991). Young Brown regards it as something we should prevent from “intruding” (2004, p. 65), while Millichamp sees it as a source of “aliveness” (2018, p. 68). Like Ferenczi, Millichamp recommends it be shared, while Firman and Gila are circumspect about its propensity for activating the therapist’s own wounding (1997). They discuss “traumatic countertransference” (1997, p. 241) where the therapist’s activated unconscious material impacts the therapeutic relationship. In response, the therapist may take a “positive unifying centre position” (ibid) and in the attempt to rescue the client from trauma, as in “It’s going to be OK!”, minimise the client’s experience. Alternatively, the therapist may take a “negative unifying centre position” (ibid), finding themselves irritated by the client’s vulnerability and becoming critical. 

Firman and Gila’s views are couched in terms of the activation of the therapist’s unconscious wounding. The possibility of negative responses relating to objectively unattractive aspects of the client, or to intersectional issues like those that emerged between myself and my antisemitic client is not explored. Yet, the fact that intersectionality impacts therapeutic outcomes is confirmed by studies where racial matching, for instance, improves treatment outcomes (Scharff, et al., 2021). 

Arguments around black clients needing black therapists rotate around the value of cultural alignment (Johnson, 2022). Those who advocate the measured disclosure of counter-transference assume that by realising how they are projecting unwanted aspects of themselves onto the other, therapist and client alike may reconcile their respective needs (J.D. Sutherland, cited in Halmos, 1965 p.189). Might this be equally so when the client is perceived as an existential threat? My client raisedthe hairs on the back of my neck. Might that be reconciled by sharing? I was left wondering if the model offers sufficient framing for the kind of visceral, autonomic nervous system response I experienced? To that end, I will end this literature review by looking at the disgust response. 

 

The disgust response 

The extreme form of counter-transference I experienced with my antisemitic client (p. 8) was I believe, the disgust response. Thought to derive from bitter tastes, disgust can be evoked by stimuli varying from the simple physical, to complex conceptual abstractions; stepping in excrement, or just the thought of stepping in excrement. Disgust may also be activated by differences between people; unconventional table manners, moral or political differences (Herz, 2012). It is thought to play a major part in social tensions around “class, race, and ethnic divisions” (Miller, 1997, p. 205). Its suggestible, affective power has been harnessed to various ends. Correctional institutions have experimented with odours designed to inhibit sexual arousal amongst sex offenders. In Mein Kampf, Hitler used the body as a source domain for metaphors of the German state, invoking the disgust response by describing Jews as “maggots in a festering abscess” (Rash, 2005, p. 106). In Rwanda in 1994, the genocidal slaughter of Tutsi “cockroaches” (Herz, 2012, p. 193), was presented as a matter of public sanitation. 

Disgust itself may be universal, but what activates it is uniquely personal. Our age, personality, culture, beliefs, etc. all contribute to the shaping of our own unique disgust profile. In effect, what we find disgusting, is learned. My father’s Holocaust survival likely underpins what in me construed Holocaust denial as a threat. Another counsellor might be quite untouched. 

Bowlby’s adaptive conjectures; the drive to bond with others and the contradictory fear of strangers are both supported by evolutionary biology. Young (2003) correlates the emergence of our neural capacity for love with the development of pair-bonding sometime around three million years ago. Fear of strangers is thought to hark back to the time when our species was cannibal and also represents an adaptive response to genetic dilution (Hahn-Holbrook, et al., 2010). Crucially, unlike other emotions, the disgust response is mutable. Disgust that is learned, can also be unlearned. We can develop tolerances or even come to enjoy what at first, we found disgusting Olives, anchovies and blue cheese are all ‘acquired tastes’, as is immediately obvious from a child’s reaction on first encounter. I would be alert in my interviews for any sign that my participants had encountered the disgust response. 

 

Intersectionality 

I’m left wondering about the disgust response and its relation to intersectionality, the interconnecting and overlapping systems of advantage and disadvantage in society (Center for Intersectional Justice, 2020). Herz demonstrates how disgust is activated by difference, and we are all so different. Miller argues that disgust permeates “the contempt teenagers have for adults, women for men, servants for masters, workers for bosses, Jews for Christians, blacks for whites, the uneducated for the educated, and so on” (Miller, 1997, p. 207). It seems especially important to me now that psychosynthesis training continues to include its thematic module on intersectionality. 

••• 

Closing positions 

I began this dissertation with a statement of my opening positions. I thought I would end this literature review with a summary of the changes to my thinking that have emerged from my reading. 

•I started out believing that the form of reparative love necessary to psychosynthesis was agapé. Andthat it, like the will, may be consciously cultivated by the therapist and brought to the room. I’m ending, with a sense that love is a process that is co-created within the therapeutic alliance. It might take time to arrive and can come in many forms. 

•The disgust response came as a surprise and made immediate sense of the feelings about my clientthat prompted this research. At first, I imagined it as distinct from counter-transference. But, in the same way the autonomic aspects of erotic transference and erotic counter-transference are recognised within the model, I wonder if we shouldn’t see the disgust response in the same light. 

 

Chapter 3 Thesis 

This chapter specifies the main research question and sub-questions derived from the expanded thinking gained from the literature review. 

My original research question sought to understand how experienced psychosynthesis therapists conceptualise and work with situations where they can’t find love for a client. The couching of the question, reflected my view, endorsed by key thinkers in psychosynthesis, that where love can’t be found, therapeutic outcomes will be compromised. From my training, I had come to believe that the ‘good enough’ therapist, brings love to the room. The literature review challenged these positions and produced a revised set of questions. 

 

How do psychosynthesis practitioners conceptualise love in their practice?

This question preconfigures any exploration of the strategies participants might employ when love can’t be found. The literature review left me wondering if and how the platonic forms of love; agapé and eros, might influence my participants, or if their positions on love rely on something else. It also challenged my perception of love almost as a commodity, brought by the therapist to the room. Did my participants also hold love as the essential determinant of therapeutic outcomes? 

 

How does the theoretical position of love as essential, configure our response to it?

What also preconfigures participant strategies is whether or not they also view love as an essential ingredient in successful therapeutic outcomes. This position will determine their response to situations where they can’t find love as well as the likely impact that situation has on them. It may also determine if and how they navigate any ethical issues arising. 

The literature review also offered a completely new perspective on my visceral reaction to my antisemitic client. It challenged what I otherwise might have imagined as simply a matter of negative or traumatic counter-transference and left me wondering whether our current conceptions of counter-transference, makes sufficient account of autonomic responses. 

 

Is the disgust response just another form of counter-transference?

In preparing for my interviews, I made a mental note to watch for any evidence of the disgust response and how my participants might understand such effects. 

My call for participants specifically sought contributors with experience of the situation addressed in the question and who were willing to share their stories of impact and resolution. The research interviews hope to elucidate these questions through participant’s direct experience in practice. 

 

Chapter 4 Methodology 

This chapter details the reason behind my selection of research method and the process which I followed from data collection through analysis. 

 

Study design 

From the outset, I assumed this study would employ a qualitative research methodology. That is, its findings would not assume any objective reality, nor rest on a quantity of numerical data, but would rely on an exploration of participants’ beliefs, experiences, attitudes and behaviours “from the point of view of those being studied” (Bryman, 1992, p. 46). Qualitative methods take a subjectivist ontological position akin to the position of a therapist exploring a client’s lived experience; reality is subjective and truth is both plural and socially constructed (Ibid). 

Within the range of qualitative methods, Interpretative Phenomenological Analysis (IPA) seemed most suitable. Not a theory generating approach like Grounded Theory, IPA explores through interviews the participants’ lived experience of the subject under study (Smith, et al., 2009). The most likely alternative method would be Narrative Analysis (NA), another ‘meaning-making’ process rooted in the lived experience of the respondents. Like IPA, NA is phenomenological; exploring experience “in its own terms” (ibid. p. 6). But, while NA weaves sequences of events into meaning, IPA focuses more on the experiences themselves, understanding the essence of related phenomena by identifying common themes. Approaches to data analysis also differ. NA identifies stories and causal chains to develop themes, while IPA extracts significant memes to elaborate the essence of an experience. 

Data collection was done through semi-structured interviews which, by relinquishing some of the control of structured interviews, allows open dialogue to throw up broader responses to the question. IPA examines each lived experience (phenomenology), before drawing any conclusions and allows for multiple meanings (hermeneutics) and interpretations to be traced, including the impact of the interviewer and the interview itself on the process (Alase, 2017). Account is also taken of the interviewer’s own construction of the participants’ meaning making. This making meaning of meaning making, defines IPA as a ‘double hermeneutic’ process (Smith, et al., 2009, p. 7). 

Given time constraints on this research project, I determined to interview no more than four participants. Such small numbers typify IPA studies and are generally considered sufficient. 

 

Research Participants 

I employed a ‘purposive’, or ‘non-random’ sampling method (Smith & Eatough, 2006, p. 48), to identify participants. Participants would have to meet specific criteria for inclusion in the study: they must have been trained within the psychosynthesis model, have at least three years of experience in practice and have had experience relevant to the research topic. To find them, an advert was placed in the Psychosynthesis Trust newsletter of April 2023 (Appendix 1). Two applicants didn’t meet the criteria. Three qualifying applicants emerged over the following fortnight, and I was disappointed that none were men. So, for balance, I reached out to male psychotherapists within the psychosynthesis community with an email broadcast. One replied in the positive and I added him to the participant’s roster. Brief details of participants’ qualifications are included in the table below. 

 

Table of participants Name (pseudonym)	professional role/s	gender	years in practice
Halima	Psychotherapist & supervisor	Female	20+
Dan	Psychotherapist & supervisor	Male	10+
Sarah	Psychotherapist & supervisor	Female	8+
Lucy	Psychotherapist	Female	6+

Ethical Considerations

My primary ethical concern is to ensure my findings represent a fair and accurate reflection of my participants’ views and experiences. This includes communicating those concerns well enough to the participants to gain sufficient trust before the interviews proper. I hoped to demonstrate trustworthiness by being open about my pre-existing positions and included a brief positionality statement along with the framework for discussion as part of the participant enrolment process (appendix 2).

 

Ongoing informed consent

In terms of ongoing informed consent, participants were asked to sign a consent form at the outset and to approve transcripts once they had been mechanically generated and manually checked for accuracy against the recordings. Actually, most participants waived the need to check their transcript, though I sent them anyway. I felt this represented some trust which had been established between us. Later, my draft findings were also provided to each participant with a request that they either approve or comment upon my use of quotations from their contributions. It was also made clear that material alterations made by participants would be identified and may be used as part of the iterative process.

As part of my assurance of confidentiality, all participant identities are obscured and all audio files and transcripts are stored in a purpose built, password protected database. In regard to protecting therapist–client privilege, I asked participants to ensure no specific clients are identifiable either directly, or indirectly by association with themselves. One participant asked for their own pseudonym to be changed to better represent her Muslim heritage. I explained that I’d consciously disguised her with a Christian forename, worried that in such a small community a Muslim name might risk her true identity being deduced. But she insisted it be changed and I complied.

I had also considered how the psychosynthesis community could be negatively impacted by this study. The nature of the question might suggest some notional ideal psychosynthesis counsellor. But that there are as many ‘ways’ to practice psychosynthesis as there are practitioners militates for deep reflection on every key aspect of our modality.

 

Data Collection and analysis

Interview questions (appendix 4) developed with help from my peer group, were open and designed to elicit detailed descriptions of respondents’ experience with plenty of space for extrapolation. Each interview lasted seventy minutes, including ten minutes for meeting and greeting. Each was recorded to audio and transcribed via an online transcription service. Once the machine transcriptions were complete, all files were deleted from the online platform. Transcripts were verified for accuracy before formal analysis began. The analytical process followed principles outlined in Smith & Eatough (2006). Each transcript entry was annotated with notes which engaged with the content at a conceptual and linguistic level and included personal observations and associations that emerged through the process. An example from my interview with Sarah is shown below.

Loc.	Transcript	Notes
36 Res.	Sounds like the work is very long term and ongoing. It leaves me wondering what impact it had on you at the beginning, when you began to recognise your own revulsion for this person. That wanting to physically remove yourself, for me, sounds a little bit like what I’ve been talking about with the edge of disgust, where the other is responded to, again, with the Amygdala, almost as if they’re a pathogen.
37 Sarah	Yeah, there was something of that and there was a particular thing they did in the room that has nothing to do with me, it was not… it didn’t involve me and it wasn’t aimed at me, it was a habit they had that evoked that even more so. But there was nothing wrong with what they were doing. And I was aware that that particular thing used to make me… I used to get that sort of feeling just before you gag… that strong sense of disgust, or you know, it would make me feel quite ill.	97. Respondent notes certain innocuous habits their client had which made them feel queasy. This suggests that once the disgust response has arrived, innocent aspects of the client are ‘coloured’ by it.
38 Res.	I mean, what you’re describing is really absolutely core to what I’m trying to investigate. It’s not… people talk about dislike, and it is a very extreme and visceral form of dislike, very embodied and you’re talking about the gag reflex, is directly related to the elimination that disgust brings up where you vomit, and you poo and you, you get rid of anything you’ve ingested, which may kill you. So, it’s really fascinating to hear this, but I’m interested in how you felt, experiencing this with a client. And whether at some level, it challenged your feelings about what you were capable of as a therapist?
39 Sarah	Well, it did. And I began to wonder, you know, I used to fantasise about how I could get them to leave. And in that sort of philosophical way, about, you know, the ethics of you know, how I could do it and what I could say and realised I couldn’t and how I got over it was imagining… because the behaviour they had was something you’d often see in a very unconscious and uninhibited way in a small child. In my mind, I just saw a three-year-old doing it. And I realised that I didn’t have a problem with a three-year-old doing it. I had a problem with an adult doing it.	98.            Resolves her own judgement by re-imagining client as child (invoking bi-focal vision?). 99.            Attempting to resolve the ethical dilemma in referring out, she chose to keep working with the client, despite the presence of disgust. 100.         Perhaps, blames client for the work not helping issues.

 

Working from transcript notes, certain themes emerged reflecting both the extant content and my interpretation within the double hermeneutic (p.25). These themes were clustered in a superordinate and subordinate hierarchy, recognising the relatedness between thoughts and impressions.

Note nº	Theme: The nature of therapeutic love
	Sub theme: love as a performative skill
1.	Love as a performative gesture, relying on art rather than genuine feeling happens when love isn’t found.	I
2.	Without love she is more conscious of the arrival of a counsellor sub-personality.	P
3.	When love is not present, she is conscious of some self-censorship.	P
4.	Used a metaphor of a doctor’s bedside manner to describe the soft skills that support technical skills.	I
5.	Respondent may be more skill oriented than love oriented.	I

 

As a container for the research process, I used a relational database that links each transcript entry with its annotations and themes. Record numbers provide an audit trail shown in brackets throughout the findings.

 

Reliability and Validity

In qualitative research, trustworthiness is a reflection of the extent to which the scientific method has been followed in the exploration of whatever it intended to explore (Carmines & R.A., 1979). In support of any claims to knowledge and acceptance in the wider community, validity and reliability are central to trustworthiness in qualitative research. Validity refers to the degree to which a study does measure what it claims to measure. Reliability refers to the degree of consistency with which the measuring is carried out. In that sense, reliability evaluates the repeatability of the research as proof of its validity (Ibid).

Interpretative phenomenological analysis (IPA) is a qualitative approach which aims to provide detailed examinations of personal lived experience. It is expected that, two researchers, studying the same phenomena, may interpret their findings very differently. For these reasons, qualitative researchers have developed specific criteria to assess validity (Yardley, Rhodes, & Camic, 2003).

Structural corroboration, assesses the preponderance of evidence in the data that supports a particular contention. It might be compared to the circumstantial evidence in a trial.

Referential adequacy, refers to the degree to which what the work describes is readily perceptible by the reader. It rests on the purpose of qualitative research as an enlarging of human understanding and tests whether such an understanding is illuminated by the work.

Consensual validation, recognises that while two studies may produce different results there is a sufficiency of overlap to promote confidence in both. For instance, independent studies of a full English breakfast might include eggs and bacon and be consensually valid. The inclusion of apple crumble in one might undermine its validity.

 

Reflexivity

The concept of reflexivity is a key aspect of IPA studies, describing and mitigating how the process of data gathering and analysis itself might impact the outcome. It recognises the responsibility the researcher assumes when they take on the task of making meaning from other humans’ stories (Ashmore, 1989). That responsibility includes being mindful of the social constructions of the other and the process of othering.

 

Reflexivity vs reflection. 

The interpretivist ontological position I adopted for this study, is focused on the intersubjective realm; that is, on the interactions between ourselves and our world. Reality is fluid and co-constructed; “representation and object are not distinct, they are intimately interconnected”  (Woolgar, 1988, p. 20). What distinguishes reflexivity from reflection, is that reflection often takes the form of a concern for process; ensuring participants are represented in their ‘true’ light, for instance. In that sense, reflection can veer away from the intersubjective, interpretivist position, towards the positivist goal of ensuring ‘accuracy’. Reflexivity, on the other hand, is a more open enquiry into self in relation to the subject at hand, reflecting my own experience back to myself. It serves as a dialogic that allows for many layers of interpretation.

To support reflexivity in my process, I kept a research journal which was as much a jotter and doodle pad as a narrative account, except inasmuch as each day’s date was appended to an entry (See below). I also used therapy and supervision to process my changing understanding of the task.

Chapter 5

Research findings

This chapter presents the findings from the interview data; the themes and sub themes which emerged through that process. (Transcript excerpts are referenced by number.)

Following the methodology described earlier (p.25), three superordinate themes emerged from the interview data along with a number of subordinate themes:

 

Theme 1. The nature of therapeutic love 1.1            Defining love in practice

1.2     All you need is love?

Love given as a defence against love received

1.3     Love as a performative skill

 

Theme 2. The impact of the unloved

2.1     Demoralisation and resilience

2.2     The disgust response

 

Theme 3. Coping with the unlovable client

3.1      Ethical dilemmas

3.2           Remaining related

3.3   Useful models

Disidentification

Inner child

Bifocal vision

3.4     Use of supervision

 

Theme 1. The nature of therapeutic love.

1.1 Defining love in practice

Attitudes to the overall research question will be impacted by participant positions on love. So, I began each interview by asking each participant their own views of this key concept.

My strategy for the interviews was to address our respective concepts of love at the outset. I hoped this would help me hold each participant’s response to the central question in the light of their own lens on love. I noticed I felt some awkwardness around the question “What does love means to you?” and sensed something of the same in my interviewees. I wondered if perhaps we are all tinged with the ‘professional embarrassment’ that Keys speaks of (p.10) (2017). I wondered if I might not have heard more definitive responses had I asked about their definitions of will. As it was, participants’ views emerged more in the overall discussion than in answer to my direct question. Done again, I might change my strategy.

Of love, Sarah said it’s a “feeling and a state of being” (78). I wondered if she meant something akin to my own experience of love as having distinct physical and perceptual sensations (p. 10). For Halima, love is more of a process, “a multifaceted journey” (124). “it’s not about necessarily feeling all warm and fuzzy all of the time. It’s to do with erm… and I would say it’s a willingness to be present to and with the other, regardless of external circumstances.” (126). Dan spoke of “accepting what is… in whatever way it manifests” (177). He also described the summoning of love in terms of an act of will. “When it’s not as strong, I need to consciously prepare myself and invoke it.” (179). Lucy felt uneasy about “nailing a definition” (5), before describing love in terms of emerging, “something that grows” (67). This felt distinct from the Firman and Gila’s sense of love as a quality inherent in the therapist. Lucy also crisply distinguished love from ‘unconditional positive regard’– a comparison I hadn’t come across before. “Unconditional positive regard is more of a passive acceptance” (60), she said. “Love is more active; more engaged” (60). This comment matched my own perception of there being something rather anodyne about the term ‘unconditional positive regard’. She surprised me by adding that love is more ‘conditional’ than unconditional positive regard, “it’s almost like I’m giving up a bit of the unconditional, in the sense that I really have affection for them as a developing human being” (8). She described herself “looking forward to sessions” (10) with loved clients; having “additional impetus to work with them” (15). Her perceptions of love struck me as more erosic (Soble, 1989) than agapaic.

Certain qualities were referenced by all participants: “empathy”, “compassion”, “free flow of energy”, “patience”, “holding” and “meeting the client where they are”. Halima spoke of the difference between empathy and compassion when she spoke of a client with an extreme presentation. “Empathy is, I feel what you’re feeling. I can bear to be… I can bear to share your pain with you” (129). Where empathy had not been possible, compassion was available; defined more as “my heart is available to walk alongside you” (129). Halima’s approach to love felt more agapaic than erosic.

Sarah and Lucy seemed very focused and quick in response. At risk of reinforcing a stereotype, Halima and Dan seemed gentler, softer spoken. They often expressed themselves in transpersonal terms. Recognising the client’s “most essential humanity” (Dan: 181), and “holding the totality of the [client’s] soul in the frame of love” (Halima: 132).  

Sarah said emphatically, “love is cancelled by fear”. I asked her about Bion’s dictum that there should be “two frightened people, the patient and the psychotherapist” in the room. (Bion, 2005, p. 104). She didn’t disagree, but insisted that any fear cancels love. Where did that leave her in terms of working with love? I asked. She described it in terms of consciously working with fear as counter-transference;

“the recognition and ownership of the fear starts to reduce it. Which makes you more available again” (84). This was a good example of a negative counter-transference being used to positive effect; not in terms of a disclosure, but as a factor informing the work. She spoke of the patience that allows love for therapist and client both, to emerge gradually, “…you have to let go in some respects, you sort of recognise in the bifocal vision the potential for the client and then let go of the progress under which they may get there” (214). On the other hand, she also owned some impatience with lack of progress, “Love is also about action. And sometimes that action can be fierce.” (91). In Plato’s terms, Sarah seemed to hold a combination of detached agapé and goal oriented eros.

 

1.2 All you need is love?

How essential they regard love to successful therapeutic outcomes will impact participants’ views on the research question. This was not asked as a direct question, but was drawn from discussion.

In the literature, love is described as essential for “healing and growth” (Firman & Gila, 2010, p. 5).  Halima echoed this directly, “as a psychosynthesis counsellor, I believe it is love that heals.” (173). But also spoke of difficulties that position had presented earlier. “I thought, that’s how I had to feel about my clients. I had to like them. And then I had to love them.” (125). When her supervisor told her she could be of therapeutic value even without liking her clients, it removed “a really heavy weight” (131). Off the hook of obligatory loving, love remains central to Halima’s practice; if not for the presenting personality, for the soul. “Where love can’t be found”, she says, “a frame can be found through which the soul can be honoured” (138). Interestingly, she also wondered if the attempt to love all one’s clients might not “become a grandiosity” (133). For me, the word ‘grandiosity’ correlates with narcissism and raised the question of how the implicit invocation to bring love might impact therapists, especially the newly qualified. Might it not lead to some identification with the transpersonal and the possibility of “spiritual bypassing” (Firman & Gila, 2010, p. 171). Unfortunately, this is not the right place to explore that question.

Love appears to be an absolute requirement for Dan. “We need to love the being who is the client” (181). For Lucy, while love is not considered essential, unconditional positive regard, the ‘passive acceptance’ she’d described earlier, absolutely is. Though love is absent, she suggested, the client may still be getting what they need. “Of my clients past and present, I have had ‘good enough’, unconditional positive regard for, but I wouldn’t say that all of them I had love for.” (7). Lucy’s previously rather erosic position on love, unencumbered by the need to bring love, now seemed rather agapaic in its detachment.^[1]

Sarah, whose views on love and fear seemed so emphatic, was equally sure that love is not an act of will and remains unmoved by any necessity for its presence. Rather, it is an unfolding process that needs “just staying there with it” (89). Yet, later she said love is “something that can be created, even with resistance to it” (80). She’d earlier indirectly referenced counter-transference around working with fear. Again, ‘creating’ and ‘resisting’ suggested how she used counter-transference, negative and positive, to inform her work. For Sarah it seems, there is no differentiation between positive and negative counter-transference.   

 

1.3 Love given as a defence against love received

When I asked Sarah to say more about ‘resistance’, she said, “Showing love can be a defence against receiving love” (87). Adding that, “On some level (this) makes being a therapist quite a lot easier sometimes than being a client” (87). In the Lit. Review, I’d discussed how egoic resistance might mask what is being resisted (p.12). In how an outpouring of love may be stifling its inner absence, Sarah was perhaps pointing to the same effect. Halima made a similar observation later, saying how receiving love “without being defended against it” (161) can be difficult for a therapist. She spoke about feeling “nervous and edgy“ about love; “around the professionalism of that.” (164). Again, I was reminded of Key’s professional embarrassment around the word ‘love’. But, “clients need to love us, and we need to receive that love”, Halima said (164).

 

1.4 Love as performative skill

Another aspect that challenged my own opening position was the idea that when love couldn’t be found, performative skills might suffice.

Alone of my participants, Lucy owned that if she couldn’t find love, she relied on skill and technique to offer therapeutic value. She identified a “counsellor subpersonality” (17) whose conscious effort to convey affection she likened to a doctor’s “bedside manner” (52). “I almost constrain myself more to be… to play… having open body language and posture and acknowledging and smiling and all of those things” (14). For Lucy, “clients seem to be getting something… if not everything they needed and wanted… It kind of kept me in a relationship” (54). Reflecting on the transference and countertransference activating this role-play, she described how one client, perhaps sensing technique where love might otherwise be, kept flattering her, and she responded in kind. “That experience is still sitting with me, even though we finished work a couple of years ago” (27). Her comments evoked Kohut’s “twinship transference” (1971, pp. 114-116), which signals the need for autonomy and validation. Perhaps that need was evoked in the therapist too. Millichamp talks of counter-transference as a dyadic field, permeating and extending far beyond the room (2018). My training supervisor had little time for “what belongs to who?” type questions, but would ask, “what ingredients are in this soup?”. It was a useful metaphor for the constantly shifting flavours of transference and counter-transference in the therapeutic dyad.

The notion of love as something that emerges also implies that at least in the early stages when love is not yet developed, performative skills; our ‘bedside manner’, is what fosters the therapeutic relationship. Perhaps sometimes, the intention to love is love enough.

 

Theme 2. The impact of the unloved.

Generally, adverse responses to clients are attributed to ‘counter-transference’ (Linn-Walton & Pardasani, 2014). The term ‘negative counter-transference’ refers to situations where the therapist’s dislike of a client adversely impacts therapeutic outcomes (Ibid). This theme explores how participants experienced negative counter-transference.

 

2.1 Demoralisation and resilience

The impact of my antisemitic client was shame and a questioning of my suitability for the work. I was keen to explore how my participants had responded to similar experiences.

Expecting something like the shame I’d experienced at not being able to love my antisemitic client, I was surprised to find my participants speaking more to acceptance than demoralisation. Halima said, “I have had clients who switched off zoom, and I’m like, okay” (171). Lucy, who had spoken of feeling guilt at not being good enough, said, “but because the clients seem to be getting something… not everything they needed and wanted. It kind of kept me in the relationship” (Lucy: 48). It seemed that they had learned to make accommodation with what was. Lucy in particular made me wonder about how I myself held the concept of meeting all needs. Their understanding of where they were in relation to their client at each stage enabled them to respond naturally and authentically as the work unfolded, even under pressure. Dan, who spoke of sleepless nights after a sustained attack by a client, also spoke of his curiosity about his client’s perspective. “Why is this client needing to attack me? What is that serving? I suppose… you know. How is that in service of the being?” (183). He chose to stay in the relationship. “I mean, of course, I can choose not to engage with it. I can make that choice. But that wouldn’t be in service” (Dan: 198).

Dan was the only participant not to use the term counter-transference^[2] directly, though it was clear that he too was using the concept continuously to inform his work. I had no sense that any participants actually differentiated negative from positive counter-transference, or met those flavours any differently. In that sense, counter-transference felt less like a spectrum between good and bad, and more like a pendulum, tracing the ebb and flow of the work. The widening that psychosynthesis has brought to the concept of counter-transference (p.20) was evident in how participants held transpersonal aspects of themselves and the client in the frame. Sarah, for instance, spoke of how she would see “the potential” (214) in the client and hold her patience, “I had to allow them to develop what they ought to have developed when they were younger” (105). Halima spoke of focusing on her breath to remain in proximity of a client who presented sexual abuse and murder. “My internal container was stretched and it grew.” (181). Dan hardly found words to describe what he meant, “how do we call it? A moment of intimacy, a moment of connection with another level or something. I don’t know.” (180).

What emerged consistently from the data, in terms of the impact on the counsellor of finding themselves unable to love a client, was a sense of mature resilience; a workaday commitment to sitting with whatever comes into the room.

 

2.2 The disgust response

Having discovered the disgust response in my earlier reading, I was alert to any data, especially related to counter-transference, which might also signal this autonomic effect. 

Each participant described at least one experience of finding themselves unable to find love for a client. Lucy described a woman who habitually arrived unkempt and unwashed. “I occasionally felt threatened they were going to engulf me. And that scared me. And I didn’t allow myself to go there.”

(41). Body odour is a universal trigger for pathogen-avoidance (Curtis, 2007). Lucy’s “visceral fear”

(48), strongly correlates with the disgust response. She rationalised her response through the countertransference framework as the activation of unconscious material. “I felt a strong sense of having to fight to be born. There’s something that’s obviously a very old part of myself. Yes, it’s an internalised belief that as long as one is alive, one fights, and people who don’t, who give up, I guess, disgust me.” (48). “There were moments when I felt I had done good enough work with that client. And I guess I didn’t allow the transferential field, or my own counter-transference to intervene… to such an extent where I was completely berating myself.” (36).

Sarah spoke of a client whose persistent tears generated frustration leading to deep antipathy. “What I found repulsive was the self-pity” (102), suggests the disgust response. Somatic responses like “I always wanted to move away from them” (94) and references to elimination; “that sort of feeling just before you gag” (97) strongly correlate. I wondered if her client’s identification as victim hadn’t activated an extreme form of the drama triangle’s perpetrator position (Karpman, 2014). Perpetrator disgust (Curtis, 2007) is recognised in the excessive cruelty of victors towards the vanquished, as a survival instinct (Munch-Jurisic, 2022). Sarah’s reflection on the counter-transference recognised the layer that objectifies disagreeable aspects of the other. “If you see it on the countertransference, it’s like… God, I really dislike you… because… you’re really dislikeable” (110). It contrasted with the blind-spot described earlier (p.10) where objective disliking is not seen as countertransference, but as personal failing.

Dan experienced catastrophic self-doubt after a client of just a few sessions threatened formal complaint. “I went into defending myself, if you like, protecting myself, you know, I lost contact with the love” (190). While he described his struggle to reconnect with love, his language bore no trace of disgust. The rupture was reconciled and has since proven to be a turning point in the work. “A profound rupture, was probably quite necessary.” (204).

Halima described the impact of one particularly objectifying client as “diminishing my humanity” (152). She used the term “icky”, (152) which Merriam Webster define as ‘offensive to the senses.” For me, icky is more specifically related to the way it’s used by the beautiful people of Love Island, where it signals the apprehension of disgust. Being objectified in itself doesn’t suggest pathogen avoidance, but the disgust response is ‘learned’ and certainly responds to conceptual triggers (Curtis, 2007). Halima’s disgust may have been triggered by literally toxic masculinity. “…he sexualised every encounter with me.” “…and so, the counter-transference pressure of the scenes with him… the sexualising every woman, you know… every woman!” (139). Moreover, Halima has a strong religious faith. Overtly sexualised behaviour may have impacted her in ways specific to her belief system. It seems quite possible then, that intersectional outrage may have triggered Halima’s disgust response. In another case, Halima reported focusing on her breath to enable herself to remain in physical proximity to a client who after many unremarkable sessions, presented child sexual abuse and murder.

 

Theme 3. Coping with the unloved client.

I began this enquiry assuming that not being able to find love for a client would produce ethical dilemmas, likely in some cases to end in referral. I asked how they had managed to overcome, or ignore their adverse feelings.

 

3.1 Ethical dilemmas

Only two participants referenced referral as part of an ethical dilemma; (Halima: 76) and (Lucy: 54), though Sarah talked of the harm potential in her bringing therapy to an end, “they would probably experience that as a rejection. So, they will need to leave me, I can’t leave them.” (117). None actually made referrals. Halima summed up the general view, “because even that guy who is acting out in a really disgusting way. I mean, the impulse, really, is to find love. Is to find attachment.” (159).

 

3.2 Remaining related

Sarah described working to re-frame her visceral feelings, coming to view her client’s irksome behaviour as a necessary part of their maladaptive coping skills. Once she felt them begin to respond to treatment her own feelings softened (95). Later, recognising the client’s experience of negative responses from others, she said “one of the reasons they’re in the room with you is because they know everyone else dislikes them too” (113), she later found ways to be direct about what she’d found objectionable. “They burst into tears. It was such a relief to hear someone say that.” (113).

Halima felt well supported by her supervisor’s reassurance that she was “holding aliveness in the face of how dead he feels.” (151). Staying in relationship demands effort, “I have to just be able to tolerate being in the space with them.” (153). Exposure did not entirely mitigate her original feelings, “sometimes in my counter transference response to clients, I can have a thought… which is a sign of alarm… which is are they going to move forward?” (156). Dan, who hadn’t displayed signs of the disgust response, used the deep rupture with his client to strengthen his practice, “this is another dimension and another level of understanding of my work as a therapist. I really needed to become that bad object.” (193).

 

3.3 Useful models

I asked participants what psychosynthesis models and theories were most helpful in navigating their situations. 

Disidentification

The concept of transcendence/immanence describes how even when we are entirely enmeshed in the experience of living a life, we are also a ‘Self’; a soul on a journey with purpose. We are at once both ravelled up within, or “identified with” (Assagioli, 1973, p. 46) and yet distinct, or ‘more than’, our experience. Assagioli speaks of “disidentification” (ibid) as a deliberate shift to an observer position, recognising that the observer is not the same as that which is being observed. Thus, we may be angry and act out our anger; becoming our anger, or we might disidentify and observe the workings of anger as if from the outside. Lucy addressed the concept as “the more than” (42). She spoke of her client disidentifying from a “victim subpersonality” (42) and herself as disidentifying from her “perception of her client as a victim” (42). Only Lucy directly referenced disidentification, but the implicit concept of “subpersonalities” (Assagioli, 1973, p. 44), was referenced by all four participants. It describes the multiplicity of human nature, where instead of a single unified personality our minds are a constellation of different tendencies, sometimes in conflict with each other. Halima, for instance said, “this is where I think psychosynthesis really supports me at the bedrock of my practice, which is that a particular subpersonality or behaviour or mindset, I can hold as an expression of a part of that person’s psyche.” (159). The identification/disidentification model and awareness of subpersonalities within themselves and their clients seem to have enabled participants to both manage their own transference and make empathic use of the counter-transference.

 

Inner child

Sarah spoke of the centrality of the inner child model to her work and especially in managing ‘difficult’ clients, “if I can find the child in the client, even if it’s in a cage, even if it’s like a wild animal, if I can find the child, I can work with them.” (213). Sarah tuned into the “felt-sense of a wounded child” (203), “it gave me really a sense of how difficult it is for her.” (205).

 

Bifocal vision

The most reparative concept consistently referenced by all four participants was bifocal vision (p.8). Dan described it as “the most profound concept Assagioli gave us” (187). Across the data this unique psychosynthesis perspective helped participants engender empathy and sustain the therapeutic alliance. The transpersonal aspects of psychosynthesis were also most evident in references to bifocal vision: “Self is imminent and present in all things” (Halima: 168). And, “it’s kind of me getting out of my own way with who I think the client could become. And accepting, that it’s their becoming.” (Lucy: 76). Their descriptions of bifocal vision reminded me again of switching perceptual modes as the fluxing of love and will, moving into and out of moments of agapé.

 

3.4 Use of supervision

I didn’t ask a direct question about use of supervision, but tracked participant’s reflections from their responses to other questions.

For three of my four participants, supervision provided important empathic support and professional guidance, helping “separate out what was my stuff and what was the client.” (Dan: 189). Sarah, a supervisor herself, didn’t reference supervision directly. I sensed this was more an intrinsic inclusion than an omission. Halima inserted the qualifier “even”, as in “there have actually even been occasions where I’ve discussed in supervision my lack of empathy for a client.” (134). This suggests some diffidence around bringing dislike to supervision. Linn Walton & Pardasani (2014) find that reluctance around discussing dislike in supervision to be widespread. Their findings may not be indicative in the context of this study as their sample included therapists with supervisors in administrative positions over them.

 

Chapter 6

Conclusions

This chapter presents a summary of research findings in regard to the questions and sub-questions presented in chapter 3 and makes whatever recommendations seem appropriate.

 

Answering the research question

I set out to explore how experienced psychosynthesis therapists conceptualise and work with situations where they can’t find love for a client. Following the literature review a number of sub questions emerged as described in the thesis (p.23). Together with the main question, these sub questions configured the participant interviews. In combination these questions are:

How is love conceptualised in psychosynthesis therapy? Is it really essential? What happens if we can’t find it and why might it be that we can’t find it?

Of course, there are no answers to these questions, but there are insights and practical usage to draw upon from the participants’ direct experience.

 

How is love conceptualised in psychosynthesis therapy?

Firman and Gila’s vision of the agapaic love the therapist can bring to the client is lofty and powerful. “Loved like this,” they write, “we find ourselves free to appear as we are, to feel what we feel, to think what we think… to discover who we authentically are.” (Firman & Gila, 2010, p. 3). But it is not representative of my participants’ views. My findings suggest that the concept of love is not defined in any specific terms, philosophical or psychological. I found no consensus amongst my four participants in the way I might expect broad agreement around other key concepts such as will. Love remains definitively elusive, ineffable and very personal. If ours is a ‘psychotherapy of love’ (Firman & Gila, 2010), it seems important that we can articulate a coherent theory of love and loving. If not, the question seems moot.

 

Love as commodity vs love as process

In retrospect, the question of “what love means to you?” was not a useful starting point. Sarah described love as a state of being, independent and not susceptible to command. The other three participants offered less definite descriptions, at least in terms of love as a noun. Their true position emerged from discussion and tended more towards what love ‘does’ than what it ‘is’. Sarah’s position also seemed more mutable in open discussion than her definition had suggested. Perhaps for definition she relies upon the universal love Assagioli speaks of, “the Spirit working upon and within all creation is shaping it into order, harmony, and beauty, uniting all beings… with each other through links of love” (1973, p. 34). In practice, she takes a more pragmatic position where love might be evoked, even against “resistance” (80).

Though only mentioned directly by a single participant, the characteristics of Plato’s eros and agapé both seemed evident in the ensuing discussions. True to its acquisitive nature, eros found expression in terms of making progress and in the fostering of emerging potential for the client. Agapé appeared more in the acceptance of what is, rather than what might be strived for. The two forms seemed intertwined in how participants described their use of bifocal vision. Dan spoke of consciously summoning love and also of opening to accept the other’s entirety. Halima spoke of breathing her way through sessions and of holding aliveness for her client. Sarah spoke of seeing potential and also of letting go of its pursuit. Love and will; transcendent agapé and immanent eros seemed to come together in the practice of bifocal vision. The combination of the two, Plato described as philia; “perfect friendship” (Singer, 1966, p. 88).

Sarah spoke of the danger of coming to identify with the ideal of an all-loving therapist.

Halima’s suggestion of ‘grandiosity’ attending such an identification, highlights the potential for “spiritual bypassing” (Firman & Gila, 2010, p. 171). I am left wondering whether Firman and Gila’s lofty vision promotes an unattainable ideal, or is just lofty enough to raise our aspirations.

 

Conclusions

• Findings indicate a lack of clarity in the way love is defined within psychosynthesis theory and praxis. Whether this constitutes a ‘problem’ for the modality’s theoretical base and for the practitioner is a question that further research might tackle.

 

Recommendations

• Psychosynthesis training could include a comprehensive exploration of the platonic models of love.
• This could include a CPD module for qualified practitioners. I have sketched a brief proposalfor such a module in appendix 5.

 

Is love essential to psychosynthesis therapy?

This question goes to the heart of how practitioners conceptualise any inability to love a client and to navigate any ethical dilemmas attending such situations. As already described, love is seen as an unfolding process. The contention that without love, “growth cannot occur” (Firman & Gila, 2010, p. 5) (Whitmore, 1991, p. 35) is not supported in the data. While each participant described early stages with clients where love was not present, growth was indicated, if only in the softening resistance to the alliance itself (Dan: 189). The data supports love as something that grows, built upon the commitment to remain engaged in the relationship; of ‘keeping on turning up’.

 

Sometimes, love is never found.

Even in long-term work, love sometimes doesn’t emerge. Still, participants felt clients had got something, if not everything they needed, from the process. (The client’s long-term attendance suggests the therapist is not fooling themselves in this.) Even where love is not present, the therapist’s ‘intention to love’ may be enough. Halima spoke of not liking a client, “but I can be willing to stay there. And that, to me, is an act of love.” (126). Dan spoke of how self-love supported him through loveless sessions and it struck me that the therapist holding love for themselves might also be modelling that quality for the client, in the same way Halima spoke of “holding aliveness” (151).  

 

Love as performative skill

After two years, Lucy hadn’t found love for her client. In this circumstance, she relied on the core conditions of unconditional positive regard. I was reminded of CS Lewis’ advice “do not waste time bothering whether you “love” your neighbour; act as if you did.” (Lindsley, 2012, p. 4). Assagioli also speaks of loving well, as an act of will. “To love well calls for all that is demanded by the practice of any art, indeed of any human activity, namely, an adequate measure of discipline, patience, and persistence.” (1973, p. 95).  

This raises the question of whether, just as a skilled musician evokes genuine emotion in the listener, might not a skilled therapist evoke the feeling of being loved in their client? Data from Halima and Lucy also suggests that where love isn’t found, skill might support the therapeutic alliance. The commitment to remain in relation, even when love is not present, was a persistent sub-theme. “There was something about us both staying in relationship and seeing where that goes” (Halima: 55). Lucy speaking of bringing her counsellor sub-personality (17), suggests the elaboration of a persona, complicated perhaps because it is present to express authenticity.

 

The ethical dilemma

Despite numerous situations where participants found themselves unable to find love for a client, there was not a single instance of referral. There may be many reasons for this, but to my mind it indicates a belief in love as a process. Even Sarah, who spoke of love more as a fixed state, saw love as being obscured rather than absent. Lucy, the only one who said she might consider referral, said she’d only consider it if she felt she’d failed to meet, the lower standard to her mind of, unconditional positive regard. As it was, she never has. Referral seems less a resolution of not being able to find love, than a giving up on the possibility of love. The harm occasioned by referral may be more damaging than continuing the work. As Sarah stated, rather than the client experiencing that rejection “they will need to leave me, I can’t leave them.” (117).

 

Conclusion

• The implicit theoretical position that love is essential to the practice, highlights a gap between theory and praxis. My findings suggest that an unnecessary level of stress is caused amongst newly qualified practitioners around the need to love all clients, always. Through experience, therapists come to see love not as a quality inherent in the therapist, but as a process that unfolds within the therapeutic alliance, over time. When love is not present, it is understood to mean, not present yet.
• Love is considered rather unlikely at the start of a therapeutic relationship. It may emerge from the process, or it may not. What sustains the work and mitigates the referral dilemma is the practical utility of bifocal vision and disidentification. To repeat Sarah’s words, “You sort of recognise in the bifocal vision the potential for the client and then let go of the process under which they may get there.” (214).

 

Recommendations

• Researchers seek greater clarity around the terms used to describe variants of counter-transference: negative, traumatic, autonomic.
• Psychosynthesis training explicitly includes negative aspects of counter-transference arising from objectively disagreeable aspects of the client and the workings of the disgust response.
• Further research into love as a performative skill and perhaps contrasting and comparing the psychosynthesis concept of altruistic love with unconditional positive regard.

 

How do we work with situations where love can’t be found?  

This, my original question might seem naïve now. Findings indicate that where love isn’t found, there remains the reasonable expectation of it emerging later. But my question wasn’t about love not being found. It was about situations where it can’t be found; where it won’t be found. This seems to me to go beyond any reasonable expectation of love, or the kind of interpersonal rupture between therapist and client that commentators view as potentially valuable (Kohut, 1977) (Whitmore, 1991). Such views tend to see ruptures as client-led resistance, rather than the kind of therapist-led antipathy at issue here. Besides, rupture suggests open conflict, while in this study, none of the participants disclosed their antipathy, at least not in the direct way Ferenczi advises. As Lucy said, “Ferenczi was a braver person” (48). Besides, the depth of feeling prompted by the disgust response would likely not be useful shared with the client.

Psychosynthesis therapists tend to navigate their own antipathy using the concept of bifocal vision, unique to psychosynthesis. Throughout my interviews bifocal vision was in evidence both explicitly and implicitly in comments such as Lucy’s “it’s kind of me getting out of my own way.” (76).

 

Conclusion

• The way participants work with clients they can’t love, is by holding bifocal vision in their frame. It seems too simple a conclusion, and yet was consistently the way adverse responses to clients were managed and adverse feelings mitigated.

 

Recommendations

• Psychosynthesis training tends to ignore the issue of working with dislike for clients. I suggest it be given at least the same theoretical weight given to the erotic within the transference model.
• I’d also like to see a recognition of the workings of the autonomic disgust response added to the counter-transference and intersectionality models.

 

Why might love not be found?  

Linn Walton & Pardasani (2014) find that therapists disliking clients is quite common. They also find that therapists rarely conceptualise such dislike as negative counter-transference, tending instead to see it as a personal failing. Their study concludes that counter-transference theory needs a more detailed discussion of its negative aspects (2014). This conclusion is not supported by this study.

My participants also didn’t mention negative counter-transference, but this seems less a blind-spot and more because they don’t seem to hold such a concept. My findings suggest my participants view counter-transference as Millichamp (2018) suggests, as information about the client’s process. I imagine they naturally assume some of that information will by nature be negative.

Halima, for instance, spoke of a client who had committed murder, “and I was able to hold it and bear it.” (161). My findings beg the question of why this additional classification is needed at all.

Counter-transference theory also seems to fail to distinguish clients whose objectively disagreeable aspects might evoke dislike in any therapist, from displacements from a specific therapist’s past, which wouldn’t be evoked in any other clinician. (This lack of a detailed discussion of adverse reactions to clients and the general understanding of counter-transference as ‘displacement’, may obscure the full clinical significance of disliking one’s client.

Depending on one’s preferred approach to the theory, the disgust response would either be a matter of traumatic transference, or traumatic counter-transference, or just another ingredient in the soup. That it may be present in every therapeutic encounter, to the degree that therapist and client differ, highlights the need for unconscious bias and intersectional awareness. Remembering also, that our unconscious response to degrees of difference is also at play in our choice of clients and which clients we enjoy working with most.

 

Summation and next steps

I’d like to end this dissertation by returning to my experience with my antisemitic client. The hairs he raised, confirm to me now that I was dealing with an aspect of counter-transference I had no conceptual framework for. It didn’t fit my training, my previous experience, my vision for myself as a counsellor, or for me as a person. However, bless him, he did prompt this study. Through this process of connecting with colleagues my position on all those factors has changed. All the times I’ve thought of those invasive feelings that seem to not belong to me as projective identification, when they may have been coming from me all along. That feels like an issue. I’ve also learned that love, in therapy isn’t something I’m required to carry into the room like a tranquiliser. It’s always latent in the relationship, hopefully blossoms and sometimes doesn’t. When it hadn’t for my participants, they relied on bifocal vision, sometimes just concentrating on breathing to get them through a session. And that seems to me a reasonable answer to the question this dissertation posed. How experienced psychosynthesis therapists conceptualise and work with clients they can’t find love for is, to keep on turning up for the hair-raising personality and holding the soul of them in love.

As for next steps, I would like to see love, as the counterpart of will, given equal weight in the training. To that end, I have sketched a brief proposal for a CPD module on love in psychosynthesis in appendix 5.

 

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Appendix 1: Call for Participants

April 2023

What’s love got to do with it?

Would you be willing to contribute your experience and insight to a new qualitative study into how psychosynthesis therapists work with love?

Like Firman and Gila, I believe that unconditional empathic love is essential in therapy. Perhaps that’s true more especially for us, practicing our ‘psychotherapy of love’ (2010). So, when I found myself struggling to bring that love to a particular client it was a challenge that little in the literature helped me navigate. I don’t imagine I’m alone in meeting this situation. So, I’m setting out to explore how other practitioners might respond to the following question:

How do psychosynthesis therapists conceptualise and work with situations where they can’t find love for a client?

My name is …. I’m studying for an Advanced Diploma at the Psychosynthesis Education Trust. I believe this question of how we understand and work ethically with an absence of love has implications that can make an important practical and theoretical contribution to the field. So, if you are a psychosynthesis therapist, with at least three years in clinical practice and have experienced a similar difficulty, I’d love to hear from you. 

I am particularly interested in:

• Your personal reflections on the experience and the meaning you made of it.
• The impact on your sense of self as a counsellor.
• Any models, concepts and working strategies you found helpful.
• If and how your experience changed your approach to your work.

Ethical framework

This study has been approved by the Psychosynthesis Education Trust’s Ethics Committee and will be run under their supervision. It will also abide by the British Psychological Society code of human research ethics and with the BACP ethical guidelines for research in the counselling professions in all respects. Your contributions will remain entirely anonymous throughout and following the process.

If you are interested in contributing and would like more information, please contact me at the following email address:

(Name and email supplied)

 

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Appendix 2: Participants information sheet

April 2023

What’s love got to do with it?

Thank you for expressing an interest in my research project. It will be a qualitative study with only a handful of participants, so your contribution could be very important. I’m using a research method called interpretive phenomenological analysis (IPA). It explores your subjective experience; the thoughts, feelings and sensations around the subject of the study. In this case, the subject is the experience of being unable  to find love for a client:

How do psychosynthesis therapists conceptualise and  work with situations where they can’t find love for a client?

I share Ferenczi’s view that love is an ‘indispensable healing power’ in therapy. Being unable to bring that quality to a client I found very challenging. With your help, I hope to explore how other psychosynthesis therapists have conceptualised and navigated such a situation. I’d hope you’d be open to sharing its impact on you personally and professionally and any models you used to make sense of it. I’d especially like to know whether your approach changed as a result. I don’t intend any grand theory, only to stimulate discussion within the psychosynthesis community and perhaps prompt further research. If you’re still interested, I’d suggest the following:

• A 15 minute Zoom meeting.

We can put faces to names, discuss the study and the boundaries around your participation.

• Formal consent.

If still want to continue, I’ll ask you to sign and return a consent form. At that point we can arrange a suitable date and time for a formal interview. This will take place within two weeks.

• Interview (recorded).

Mindful of your time, the interview shouldn’t last longer than an hour and ten minutes. (The ten minutes is time for greeting and warm up) The interview will be semi-structured with some questions pre-prepared, but allowing plenty of time for your responses to unfold.

The interview will be recorded and a transcript produced for analysis and you will be sent a copy. The draft study may include excerpts from the transcript, which you will be invited to approve beforehand. Your identity will remain confidential at every stage. Two weeks afterwards I will arrange a debrief meeting of around twenty minutes. This reflexive follow-up will be an opportunity to share any thoughts which may have arisen since our interview. Following this, I will invite you to confirm your continued participation.

• Ongoing consent

If you are not happy to continue at any point up to my submission date, you may withdraw without question. If you do choose to withdraw, I undertake to destroy all recordings, transcripts and notes relating to your participation. Should you remain in the process, all records will be kept in a secure database until a suitable period after submission when they will also be destroyed.

 

Ethical boundary

At all times and in all respects, I will abide by the British Psychological Society code of human research ethics which can be downloaded from bps.org.uk. I will also follow the BACP ethical guidelines for research in the counselling professions, which can be downloaded from the BACP website at bacp.co.uk.

If you would like to continue in this process or have any questions, please contact me at:

(Name and email supplied)

(signature)

Thank you again for your interest.

 

3

Appendix 3: Participants Consent

April 2023

Participant consent form

What’s love got to do with it?

How do psychosynthesis therapists conceptualise and  work with situations where they can’t find love for a client?

Researcher:  Participant:

Thank you for agreeing to be interviewed as part of my research project. Ethical procedures for academic research undertaken from UK institutions require that interviewees explicitly agree to being interviewed and to how the information contained in their interview will be used. This consent form is necessary for us to ensure that you understand the purpose of your involvement and that you agree to the conditions of your participation.

Please read the following and sign the accompanying form to signal your acceptance.

• The interview will last approximately 70 minutes and will be recorded and transcribed.
• You will be sent the transcript and given the opportunity to correct any factual errors.
• The transcript of the interview will be analysed by (…) as research investigator.
• Access to the interview transcript will be restricted to (…).
• Any summary interview content, or direct quotations from the interview, that are made available through academic publication or other academic outlets will be anonymized so that you cannot be identified, and care will be taken to ensure that other information in the interview that could identify yourself is not revealed.
• All recording tapes will be destroyed following final submission.
• I understand that my words may be quoted directly.

Consent form

By signing this form, I agree that:

• I voluntarily take part and understand I can withdraw at any time prior to submission.
• Any transcription, or extracts from it may be used as described overleaf.
• I have read the Information sheet overleaf.
• I don’t expect any payment or in-kind benefit from my participation.
• I may request a copy of my interview transcription and make any edits I feel necessary to ensure my involvement remains confidential.
• I have been able to ask any questions I have had, and understand that I am free to contact the researcher with any questions I may have in the future.

_____________________________________   Please print your name

_____________________________________            ____________________

Participants Signature                                                    date

_____________________________________           ____________________

Researchers Signature                                                     date

Contact Information 

If you have any further questions or concerns about this study, please contact:

(Name and email supplied)

If you are worried about this research or concerned about how it is being conducted, you can contact my academic supervisor at the Psychosynthesis Trust: (Name and email supplied).

 

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Appendix 4: Interview structure

April 2023

Research questions

What’s love got to do with it?

The following questions are for you to consider before our interview.

• Can you speak to your conception of love?
• What you think love is
• What love means for you in your working approach
• How did you respond to finding yourself unable to love a client.
• What thoughts, feelings or sensations arose in consequence?

(The emphasis here is on your own experience rather than the clients’ unlovable aspects.)

• How did the work progress, or end?
• Were there any particular psychosynthesis models or theories that helped youframe your response to the situation? Or, any aspects of your psychosynthesis training which found particularly helpful?

5

Appendix 5: Proposal for CPD module on love

Love in a clinical climate

What do we mean by love?

(Personal reflection, small group sharing, discussion in plenary.)

Types of love. (Delivered material and discussion.) Agapé

Psychological aspect: altruistic, no return on the investment, abundance rather than scarcity.

Transpersonal aspect: potentiality, universality, disidentification, spiritual practice. Physical aspect: tenderness, warmth, detachment.

Eros

Psychological aspect: truth and right relationship, authenticity, aspiring, power, hope.

Transpersonal aspect: call to service, congruence, libido.

Physical aspect: aliveness, attraction, erotic desire, 

Philia

Psychological aspect: accompaniment, being alongside, empathy.

Transpersonal aspect: co-creation, emergence, twinship, I-amness. Physical aspect: aliveness + detachment 

The embodiment of love. (Practicum: in pairs. Sharing in plenary.) Take a seat opposite your partner, in silence. 

Engage gaze on the other, taking them all in, focusing on the eyes. Note feelings and especially any physical sensations attending.

Agapé.

Imagine holding them in absolute acceptance of who they are as a personality.

Imagine the journey of the soul within, from infancy to now, seeking expression.

Eros.

Witness the beauty of the other’s unique life-force and potential. Imagine championing their efforts to fulfil their potential.

Phila.

Imagine all the invisible energies connecting you to the other

Imagine lending your own life force to augment their effort to fulfil their potential.

 

Love as evolved function

(Delivered material and discussion.)

The triune brain: Reptilian/Limbic/Neocortical.

Empathy: Pair-bonding and the utility of love

 

Love in practice

(Delivered material and discussion.) Love in the therapeutic frame. Healing dimension As ‘process’ not ‘product’.

Ethical frame

The absence of love.

(Delivered material and discussion.)

The impact of difference

The disgust response

Bowlby (affectional bonds/fear of strangers) Impact of not finding love.

Edges of the therapeutic alliance.

Performative love.

Bifocal vision and disidentification.

 

Target learning outcomes

Underpinning concepts

• Assagioli’s psychological laws.

Intention vs actualisation.

• Love and will locate in different brain systems.
• Different forms of love have distinct loci of activation and perceptual effects.

Maternal/Romantic/Unconditional Agapaic/Erosic/Philial

• They may appear alone, in combination, or in conflict:

Agapé: Indifference: in tension with eros.

Eros: goal orientation: in tension with agapé. Philial = agapé + eros.

• Love and its cognates Attachment.

Unconditional positive regard.

[1] I am realising how I have taken Plato’s taxonomy of love into a rather either/or place and got stuck in boxes. My participants rarely occupy a single position and take different positions at different times.

[2] I would have given counter-transference its own heading, except that it so permeates the flow of each interview that it feels more appropriate to comment where I need to, in situ.