The embodied listener: a dyadic case study of how therapist and patient reflect on the significance of therapist’s personal presence for the therapeutic change process

Abstract

There is a need to understand more of the dyadic processes in therapy and how the therapist's ways of being are experienced and reflected upon by both patient and therapist. The aim of this dyadic case study was to investigate how the therapist's personal presence was perceived by the patient and the therapist as contributing to change. Method: From a larger project on collaborative actions between patient and therapist, a dyadic case involving in-depth interviews of the therapist and patient was selected to examine the research question. Interpretative phenomenological analysis of four interviews with the therapist and one interview with the patient was conducted. Results: The analyses indicated that the therapist's way of being, as perceived by both therapist and patient, was expressed at a superordinate level through the concept of embodied listening, which was of particular help for the patient, and influenced by the therapist's theoretical orientation, as well as being rooted in his own personal history. Three sub-themes emerged from the analysis, each illustrating how embodied listening contributed to the therapeutic relationship and process. Our findings flesh out how the underlying phenomena of emotional attunement, presence, and genuineness are observable in therapeutic encounters.

Relationship and Alliance Formation Processes in Psychotherapy: A Dual-Perspective Qualitative Study

“…For therapists, being able to help and relate to clients in a constructive way was what made it worthwhile. This is in line with recent dyadic qualitative studies, showing that technique and relationship are not separate constructs, and that the therapist combines their authentic, personal and professional parts to form a relationship that is both real and therapeutic ( Bernhardt et al, 2021 ; Råbu and Moltu, 2021 ).…”

Inside the consulting room of a highly effective therapist: An analysis of first sessions

“…For some, it is understood as a superordinate concept that allows conceptualising of how the intra and interpersonal qualities of the therapist combine in session (Bernhardt et al, 2021). Therapeutic presence is often demonstrated nonverbally, through the therapist's posture, gestures, prosody quality and discursive rhythm (Geller & Porges, 2014).…”

“…Regarding the empathic presence stance, the concept of embodied empathy (Bernhardt et al, 2021;Cooper, 2001) also seemed relevant to our analysis. It is a form of therapist's attention to their own internal experience and bodily sensations, which allows them to deeply understand the client.…”

Do therapists differ in their general effectiveness? Therapist effects and their determinants.

“…As to therapists' responsiveness within relational dynamics, they identified, for example, therapist timing and attunement, response to underlying relational needs (especially when there is tension), and change of treatment The qualitative studies in this field, while still too few, aim at getting closer to therapists' actual way of working, thinking, and experiencing, including how they process information and form decisions. In-depth interview analyses have demonstrated how therapists draw on their extended repertoire of knowledge sources, involving embodied, implicit decision making and clinical intuition (Bernhardt et al, 2021;Oddli & Halvorsen, 2014;Oddli & McLeod, 2017;Råbu et al, 2021). Qualitative analyses of therapy sessions have identified how decisions evolve as therapists make use of micro-cues along with distinctive linguistic manners, to involve the patient in a meaningful interaction about relevant tasks in therapy and future goals and directions (Oddli & McLeod, 2017;Oddli et al, 2021;Oddli & Rønnestad, 2012;von der Lippe et al, 2019).…”