Neutrality revisited: On the value of being neutral within an empathic atmosphere.

Abstract

Using psychoanalysis as a starting point, we explore the value of therapeutic neutrality in psychotherapies that seek to foster self-understanding, experiencing, and insight. Contrary to much of the current zeitgeist, therapist neutrality is posited to be a key element of effective psychotherapy in such approaches. We suggest 5 meanings of effective therapeutic neutrality: The therapist (a) takes, at least in part, an observer position in the relationship; (b) refrains from taking sides in the patient's inner struggles; (c) also does not take sides in the patient's relational struggles; (d) refrains from manipulating the patient into emotional expression; and (e) follows some guidelines about when to directly gratify the patient's dependency and affectional needs/ demands. Rules of thumb are presented about the conditions under which direct gratification is called for. However, as a bottom line, if neutrality is to be an effective stance in any psychotherapy, it must be carried out in the context of empathy, caring, and affirmation.

Persuasiveness: An underappreciated characteristic of effective therapists.

“…However, the role clinicians have in actively attempting to influence the client has historically been a controversial issue. For instance, the relative importance of therapist’s neutrality —a stance seemingly at odds with attempts to directly influence the client—remains a topic of scholarly discussion (e.g., Gelso & Kanninen, 2017).…”

Coloniality and Psychology: From Silencing to Re-Centering Marginalized Voices in Postcolonial Times

“…Traditional ideas of therapeutic neutrality emerge from Freudian psychoanalysis. By assuming a stance of neutrality, the therapist does not take sides with the inner conflicts of the patient and “portrays the analyst/therapist as distant, indifferent, and even cold” (Gelso & Kanninen, 2017, p. 331).…”

The ambiguities of neutrality: Comment on Gelso and Kanninen (2017).

“…There is no really neutral spot where we can stand, secure in the knowledge that now I am safe from error. Gelso and Kanninen (2017) offer us a useful description of one pole of the therapeutic process and valuably highlight some of the problems that can arise if one is insufficiently attentive to its contribution to the patient's growth. But their framing flattens the dialectical tensions that underlie and energize our work when they contend that departures from the so-called neutral stance should only be a part of our work when the very stability and coherence of the patient's personality is at risk.…”

“…It is not that the cooler, more restrained neutral stance is necessarily wrong. There are times, as Gelso and Kanninen (2017) illustrate, where it can be in the patient's interest. What is wrong, rather, is assuming that opting in one direction has a cost (e.g., diminishing the patient's motivation to keep exploring) but opting in the opposite direction does not.…”