Counseling and Psychotherapy

According to RCT, people are all born with an innate desire to form and sustain connections, and yet disconnections are a natural part of life. Whether disconnections are acute, chronic, or traumatic, despite people’s desire for connection, they may behave in ways that keep them out of the relationships they so badly want. Clarita is experiencing depression, chronic disconnection, and acute loneliness. She feels unworthy and hopeless. Her love for her children sustains her, and she feels tremendous guilt over her inability to care for them adequately.

The counselor would need to respect Clarita’s strategies for disconnection as they arise. She would need to remain humble in knowing that Clarita needs the time and has the wisdom to move at a pace that makes sense to her. During those times when Clarita is unable to sustain connection with the counselor, the counselor would honor that strategy, recognizing it as one born for survival.

Clarita is disconnected from her family and their love and support. She is disconnected from her familiar home, and she feels lonely and overwhelmed. Counseling would involve authentically being with Clarita in her pain and cocreating a space where she could experience the five good things. This would involve creating a counseling climate in which Clarita can feel energy from the connection with the counselor, clarity in their work together, and an increased sense of self-worth because she feels seen and valued. Over time, the hope would be that Clarita would feel a desire to increase connections with others and to be moved to act (Jordan, 2018).

Working from an RCT perspective would not preclude asking questions about suicide and developing a collaborative safety plan. Using relational ethics as a framework, the counselor and Clarita would determine what is in her best interest and collaboratively make decisions about suicide prevention as needed. If Clarita were to be in danger, the counselor would take the time needed to help Clarita find safety and would stay connected to her throughout the process.

Through this case study, one can see how the crises and traumas in Clarita’s life are relationally situated. The hope for healing is also relationally situated. Clarita experienced the central relational paradox when she withdrew from relationships yet longed for them. Movement for Clarita may come by resolving the paradox through mutual empathy, supported vulnerability, and the emergence of a growth-fostering therapeutic relationship. An RCT-focused counselor works from a place of sociocultural humility and awareness of the power differential inherent in the therapeutic relationship. The science of relational neurobiology informs Clarita’s counselor that a mutually empathic relationship will enliven the neural pathways of healing, which will open up possibilities for more complex relational connections (Banks, 2015).

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