Facilitating the sense of feeling understood in patients with maladaptive relationships

Sigal Zilcha-Mano, Jacques P. Barber

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


The association between therapeutic alliance and symptomatic change has gained increasing recognition in recent years. To further advance our ability to turn this association into helpful practical knowledge in treatment, it is worthwhile considering what the therapeutic elements of alliance are. This chapter focuses on the patient's feelings of being understood in treatment as such an element. By exploring this element, the authors study the intertwined relationship between therapeutic techniques used in treatment, and trait and state aspects of the alliance, as well as their ability to predict outcomes. The authors use two case studies of patients—both suffering from difficulties in their interpersonal relationships—who received psychodynamic treatment to demonstrate the importance of the process of building a feeling of being understood. The chapter concludes that active, collaborative therapeutic work on the patient's sense of being understood may trigger changes in the patient's patterns of relating to others. Implications of the study for clinical practice and research are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Original languageEnglish
Title of host publicationDeveloping the therapeutic relationship - integrating case studies, research and practice
EditorsO. Tishby, H. Wiseman
PublisherAmerican Psychological Association Inc.
Number of pages27
StatePublished - 2018


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