Introduction
The therapeutic relationship is not merely a healing process, but a complex interplay of power and emotion. This article analyzes Steiner's concepts regarding dependency and power within the psychological setting.
You will discover why progress in therapy can, paradoxically, lead to conflict. We will examine the patient's defense mechanisms and the narcissistic pitfalls encountered by the therapist.
The objective is to understand how to move from a struggle for dominance toward a mature acceptance of one's own limitations and the inherent need for support from another human being.
Clinical Improvement Unmasks the Fear of Dependency
Clinical improvement often destabilizes the treatment process. As the patient begins to feel secure, the necessity for aggressive defenses vanishes, which paradoxically exposes a deep-seated fear of dependency.
For individuals with a narcissistic organization, acknowledging that the therapist provides something of value is experienced as evidence of weakness. Admitting "I need this person" strikes at the illusion of self-sufficiency and dignity.
Consequently, the patient may become irritable or aggressive to mask the shame associated with feelings of inferiority. This is known as the narcissistic cost of improvement, where healing entails the loss of a previous self-image as an independent entity.
Indignation as a Narcissistic Defense Against Shame and Dependency
The shame associated with being needy is often unbearable. To avoid feelings of inferiority, the psyche transforms embarrassment into "righteous indignation."
The patient begins to exaggerate minor errors made by the therapist, such as tardiness or the cost of the session fee. In doing so, they cease to be a shamed subject and instead become a morally justified accuser.
This transformation of affect serves as a narcissistic lift. It allows for a reversal of the relational axis: rather than feeling "lower" due to dependency, the patient places the therapist in the position of the guilty party, thereby restoring their own sense of control and superiority.
The Third Position as a Space for Reflection and the Risk of the Judicial Gaze
The third position is the ability to be simultaneously a participant in a relationship and its external observer. It allows one to ask, "What is happening between us?" rather than merely reacting emotionally.
For many patients, this perspective is threatening, as the idea of being observed may be equated with judgment or condemnation. In such cases, reflection transforms into a fear of the judge's "evil eye."
The key to breaking this impasse is the therapist's renunciation of omnipotence. They must mourn the fantasy of having full control over the process in order to create a safe space where the asymmetry of knowledge is not experienced as a hierarchy of value.
Summary
True therapeutic progress occurs when dependency no longer signifies surrender. Maturity consists of recognizing functional differences without sacrificing one's own dignity.
It is crucial to distinguish between actual harm and resentment. While the former is a fact, the latter often serves as a psychological refuge and a form of desperate attachment to the aggressor, allowing the individual to avoid the process of mourning.
Ultimate liberation begins with the acceptance of the irreversibility of loss. True freedom emerges where the desire for revenge ends and the process of grieving begins.
Frequently Asked Questions
Why might a patient become aggressive or irritable at the moment when therapy begins to take effect?
Improvement in therapy reduces the need for defense mechanisms, exposing feelings of dependency and needs toward the therapist. For some patients, acknowledging the value of external help is experienced as evidence of weakness or a humiliating loss of the illusion of self-sufficiency, which can lead to a defensive transformation of shame into aggression and irritability.
Why might a patient in therapy react with anger or indignation to the therapist's minor mistakes?
Indignation over the therapist's errors can serve as a defense against shame and anxiety related to dependency on another person. In doing so, the patient stops feeling like a needy person and instead adopts the position of a morally righteous accuser, which allows them to avoid difficult emotions and maintain distance.
What is the 'third position' in psychotherapy, and why is it threatening for some patients?
The third position is the ability to observe the relationship from a distance and maintain a space for reflection between experience and action, allowing for the objectification of one's own experiences. For some patients, especially those with a narcissistic organization, this is threatening because the figure of the observer may be identified as a judge, turning reflection into a feeling of being judged or condemned.
How can the therapist's narcissistic needs affect the treatment process and lead to an impasse in the relationship with the patient?
The need for effectiveness and recognition may prompt the therapist to adopt a dominant stance or formulate a 'strong interpretation' to regain a sense of agency. This leads to an enactment, where the relationship turns into a power and control struggle instead of a reflective process. Such a dynamic freezes change, as the patient's original problems are replaced by a fight for dominance between both parties.
What is the difference between healthy dependency and compliance, and how can therapy help one move beyond the struggle for dominance?
Healthy dependency differs from compliance in that it does not mean surrender or loss of dignity, but rather allows one to need another person without feeling enslaved. Therapy helps resolve the struggle for dominance by creating a space for accepting distinctness and limiting one's own omnipotence, which enables the building of a relationship based on tenderness instead of control.
Why is a difference in knowledge or status perceived as an act of dominance in narcissistic organizations, and how can this be overcome?
In narcissistic organizations, a difference in knowledge or status is interpreted as a hierarchical message, where a lack of control over another person or one's own ignorance is equated with inferiority and subordination. The way out of this situation is to adopt a 'depressive solution,' which involves accepting dependency and authority without feeling personal degradation.
Why might a simple difference in competence or social role be perceived as humiliating dominance?
Yes, a difference in competence or social role can be perceived as humiliating dominance when local functional asymmetry is experienced as a global hierarchy of value. This occurs in the absence of the ability to segment inequalities, causing every dependency to become a threat and every correction to be felt as degradation.
Why does a struggle for dominance emerge in the therapeutic relationship, and how might a therapist unconsciously enter into it?
The struggle for dominance stems from an intolerance of one's own helplessness and a tendency to transform a state of dependency into control over the other person. A therapist may unconsciously enter this struggle when growing discomfort or a sense of incompetence pushes them toward interpretative overactivity in order to regain a sense of agency.
How can a therapist avoid power traps in the relationship with a patient, and what allows one to move beyond the cycle of dominance and submission?
A therapist can avoid power traps by relinquishing fantasies of omnipotence and accepting realistic responsibility for the quality of their work, rather than full control over its outcomes. Moving beyond the cycle of dominance and submission is made possible by adopting the position of a reflective observer and creating a space for pluralism of perspectives, which allows for the analysis of the relationship instead of a struggle to be right.
What is the difference between real harm and resentment, and why might the fight for justice be a form of avoiding grief?
Harm is an objective event or state subject to evaluation, whereas resentment is a psychological way of attaching oneself to that harm and making it the center of one's identity. The fight for justice may serve to avoid grief because maintaining the conflict allows one to postpone the moment of acknowledging the irreversibility of loss and the fact that life must move forward.
