Concealing and revealing power in the therapeutic relationship

Abstract

Despite sporadic attention to the issue, the therapeutic professions lack theoretical frameworks and empirical tools to examine the way in which power operates in the therapeutic encounter. This thesis attempts to address this situation, firstly by orienting to the ways in which power is hidden in therapeutic practice, which accounts to some extent for the limited and fragmentary attention given to the issue, and secondly by proposing theoretical and methodological tools to make power visible. In doing so, I develop a view of power based principally on the ideas of Michel Foucault. This approach to power is useful because it not only facilitates an understanding of local therapist-client dynamics, but also promotes investigation of therapy’s function in the overall sociocultural and political context. Four questions provide the cornerstones for this thesis: (1) What forces impact on participants in the therapeutic encounter? (2) How is power concealed in therapy? (3) How can it be made visible? (4) What is the relationship between therapeutic power and the operation of power at a societal-political level? Each of these questions is addressed in different ways in the studies presented, and attention is given to the empirical examination of actual therapist-client interactions drawn from a variety of therapeutic perspectives. The thesis argues for the fundamentally social and political nature of therapeutic practice. Following this series of empirical studies, some theoretical and methodological tools are proposed to enable future studies on power and therapy, a four stage sequence is hypothesised to understand how persons are shaped into the position of clienthood, and a model is offered to account for therapy’s place in power’s circulation through society.