When two people meet, be it just for a handshake or making a deeper connection, there is much more that takes place than what meets the eye. There is a kind of transaction that takes place, whether it is a mere acknowledgement or a meeting of kindred spirits. With this reference point, Eric Berne developed the concept and paradigm of transactional analysis. In that paradigm, all social engagements are seen as transactions between people in their parent-like, child-like, or adult-like ego states.

For me, the ideal state is when 2 people meet in what Martin Buber’s referred to as an “I-Thou” relationship for a soul to soul encounter. I imagine that was the experience when Martin Luther King met Thích Nhất Hạnh or Father Thomas Merton. Although they were from very different backgrounds, they related as brothers, soul to soul. What they didn’t bring into the experience was an ego defence barrier. They were completely open to one another without asserting or subsuming their background in the engagement.

Well, we are not all able to do that but we can see that as a most positive aspiration. But, let us find out what we ordinary human beings can do, as therapists and clients in a healing relationship.

I cite the religious and philosophical thinkers above because in being practitioners of science based medicine, we somehow often forget we have souls. In that forgetting, we turn away from our fundamental humanity. But, that fundamental humanity matters most when we are dealing with crisis, trauma and healing. It is the key to a successful therapeutic alliance between therapist and patient.

In looking at books regarding different approaches used in psychotherapy, I find that little time is spent discussing the very basic fundamentals of psychotherapy. Perhaps they are so self-evident that authors and teachers assume it is unnecessary to restate them. I disagree. It is always necessary to return to and remind ourselves of the foundation of therapy, empathy, which is integral to our humanity.

I respectfully request that you not let my use of a word like soul, or to speak of religious thinkers, discourage you. I use these words for that which I am unable to communicate using conventional language. Most of our speech refers to concrete things such as a chair or a pound of butter. While such materialistic terms are necessary to our everyday existence, they are inadequate in communicating the wider sense of our experience.

When we use words like compassion, empathy, and understanding, we cannot use materialistic terms. You cannot scientifically measure the love you have with your significant other. You cannot scientifically measure the pain you experience when someone close to you passes away. So, we start to use words differently. For anything beyond the materialistic world, we need to use poetic language and often metaphors.

So please allow me to use words like love, humanity and God in that way. The way I use the word God, God is not an object I can pinpoint or describe in any literal way. For example, I cannot say, “God is here, not there.” I cannot place God in a location. As with love, God has no color, no size or weight. What I reference as God is not confined by time and space. It is in that same context that I speak about “soul” as in “meeting of souls.”

Carl Rogers emphasized the critical nature of a person-to-person relationship between therapist and client/patient. That is the environment which can provide the patient with genuineness (openness), acceptance (being seen with unconditional positive regard), and empathy (being listened to and understood). To me, this is the necessary and basic requirement for the foundation of a proper therapeutic alliance, from which healing is possible.

Time and time again we are shocked when we encounter practitioners of healing professions that are lacking in such qualities. I mentioned the meeting of souls as the highest ideal. It is one that we seldom achieve. But, that is the lodestone we aspire to in seeking to create the person to person therapeutic alliance so critical to healing.

These days, patients need to make a great deal of effort to see a therapist. One must spend the time and energy getting a primary referral from one’s doctor. And then, one must phone for an appointment and often experience an automated recorded voice saying something like:

“Please hold……If you wish to speak in English, press 1. If you are a new patient calling for an appointment, press 2, if this is ……. press 3. If …………..press 4.” After days, weeks and sometimes months on the waiting list, you finally arrive at the psychiatrist’s office. Then when you see the psychiatrist, all he does is acknowledge that you are not doing so well. It can be along the lines of: “You are depressed. You need to take this medication. It usually takes up to a few weeks to work, so be patient. We will start with this dose and then see from there.” Does it sound like a therapeutic relationship, a space in which healing will take place?

All the years of learning in university are irrelevant unless we keep in mind that we absolutely must connect with a patient. Without that connection, we will be unable to help them work with their trauma. Expertise can make a difference to the outcome but if, and only if, it is leavened with empathy, with compassion, and with openness.

That is why I believe the most fundamental issue is to create a field for healing to take place. It is like sowing seeds, some fall on to rocks, and others to concrete ground. Only those seeds falling onto suitable ground, with the right amount of moisture, the right kind of soil mix, and the right amount of sunlight that will enable the seed to mature into a plant. This suitable ground for healing, this fertile milieu, is what we call a therapeutic alliance.

It is the foundation of a relationship between a healthcare professional and a client (or patient), hoping that their engagement will effect beneficial change in the client. This relationship is the milieu, the soil from which will facilitate the sprouting of a seed that will grow into a healthy plant reaching down into the earth for nourishment and up toward the sun to flower.