Love in the Therapeutic Alliance

Abstract

Volumes have been written about the patient's love for the therapist, but there has been relatively little discussion of the therapist's love for the patient. In an attempt to create a theoretical and technical space for discussing the appropriateness and role of love in the therapeutic relationship, a revised concept of the therapeutic alliance is applied to provide technical guidelines and understanding of two kinds of love between patient and therapist, corresponding to two systems of self-esteem regulation: an open, reality-oriented system and a closed, sadomasochistic system organized according to omnipotent beliefs. Examples of the role of love through the phases of treatment illustrate the interrelationship of love and the accomplishment of therapeutic alliance tasks.

The Problem of Self-Disclosure in Psychoanalysis

“…The slope may be particularly slippery in expressions of affection or endearment (Fitzpatrick 1999). We should also acknowledge that there is a legitimate place for love in the therapeutic alliance, the kind of love addressed by Loewald (1980) as an aspect of the new object relation in analysis (Novick and Novick 2000). Fitzpatrick rationalizes her disclosure as making it evident that she did not share the patient's poor feelings about himself; however, the analyst's divergent perspective would also be evident in her refusal to accept the patient's assumptions about himself and in her persistent inquiry consistent with the alliance into the underlying sources of his self-image.…”

From “It's Not Me” to “It Was Me, After All”: A Case Presentation of a Patient Diagnosed with Dissociative Identity Disorder

“…Was it a healthy, mutually satisfying love between patient and therapist or was it a "love" predicated on pathological omnipotent sadomasochist patterns based on her history of trauma? Novick and Novick (2000) explicate two kinds of love between the patient and therapist that are based on the open or closed system of self-esteem regulation. In retrospect, a deeper examination of the role of love in our relationship could have been more profitable.…”

Untitled

“…The reality of adolescent growth not only involves setting aside childhood beliefs and fantasies but also, in doing so, allows for the experience of reality attuned sources of self-esteem, pleasure, and safety. In our studies of sadomasochism (Novick and Novick,1972,1987, 1996a, 1996b, 1996c, 1997a, 1997b, 1997c, 2000a, 2000b, 2000 we have de-scribed and explored two systems of conflict resolution and self-esteem regulation. One assumes a developmental path in which adaptive solutions to conflict may be achieved throughout life in an open, competent system of self-regulation based on respectful, pleasurable, and mutually enhancing relationships formed through realistic perceptions of separate, autonomous individuals.…”