Editor’s Letter: Special Issue on Therapeutic Presence

Gil Tunnell, Ph.D

This issue of Transformance: The AEDP Journal has been over a year in the making, and I thank the eight authors for their patience! Carrie Ruggieri, the new associate editor, and I believe it has been well worth the wait and the effort, as the six articles bring together the writings of senior therapists who are well versed in Therapeutic Presence (TP).

We are honored to have among our authors for this issue, Shari Geller, who coined the term Therapeutic Presence. Other articles in this issue expand upon Geller’s concept from the AEDP perspective. Each author provides us with ways to create and maintain TP in a blend of unique styles, in the form of four scholarly articles, a very personal essay, and a highly useful toolkit for creating TP online.

All authors make the point that while we can be well trained in clinical skills and have a complete intellectual understanding of the AEDP model, these skills and knowledge should become background when we are with our patients. Therapeutic Presence demands that we be in the moment, and in the precise way of being that each patient requires, trusting that when we have settled our own nervous systems, we will intuitively know what to do and how to do it. To guide our intuition, each author offers specific ways of creating and maintaining TP.

AEDP faculty member Ben Lipton complements Geller’s TP with his own model of TP called Active Empathy: Presence, Attunement, Intention, Resonance, Reflection (PAIRR). Lipton’s PAIRR emphasizes the therapist’s act of being within the relationship. An intriguing backdrop to this article is Lipton’s reflection upon his 20 years practicing and teaching AEDP. PAIRR represents his synthesis of insights and observations that lead to his thesis that the doing of therapy is, in fact, in the act of being as therapist. Lipton’s gorgeous session transcript is ripe with the rewards of achieving Active Empathy, resonance, attunement, and flow and the promise of “surrender to the improvisational emergent truth of the moment.” You will want to read this article more than once. First for the pleasure of it, and then to uncover the layers of depth and insight.

AEDP faculty member Danny Yeung and co-author Lily Zhang describe a result similar to Lipton’s when a therapist is able to cultivate a version of Therapeutic Presence they call contemplative presence. Among the benefits of contemplative presence is the expansion of intuition, and the authors explain the neuroscience underlying intuition. The article provides therapists with specific actions to take to cultivate contemplative presence. And, as if that is not enough, a session transcript demonstrates an abundance of intuitive therapeutic moments, which the authors earmark with a “BLINK,” that move with the AEDP transformational process. The transcript illustrates what this expansion of intuition looks like in action. Personally, Yeung and Zhang have inspired me to practice contemplative presence almost daily during the COVID crisis. Yeung did a webinar on May 8, 2020, entitled “Awakening the Healing Power Within: Insula, Neuroception, Dyadic Contemplative Presence and Zhaungzi in AEDP,” which will soon be available on the AEDP website.

Wendy Summers, a certified AEDP therapist, describes how she creates Therapeutic Presence in her work with Emerging Adults (EAs). She argues that therapists must calibrate their TP to the EAs’ unique developmental challenge as they strive toward autonomy, individuation and identity. She writes tenderly of this poignant developmental challenge and proposes that EAs need their therapists to be attuned and connected while also conveying a differentiated “we- ness.” Her session transcript demonstrates her embodiment of one of AEDP’s core principles: Transformational strivings are there to be harvested as EAs discover their core self, agency and identity. One challenge for the therapist is working with the tension in EAs between dependency needs and autonomous strivings. Summers skillfully describes how to use intuition to navigate the slippery slope when being can so easily be experienced as doing by EAs.

In a lyrical and heart-opening personal essay, Marc Cecil, a certified AEDP supervisor, describes his journey into immersive TP as he accompanies his patients into their journeys through painful grieving. Using the metaphor of the “elephant” (an inspirational symbol of quiet strength despite difficult hardships) as a way into TP, he discovers that his own healing processes get underway as he sits with being with his client’s suffering. Cecil’s essay is an experienced-near account of AEDP principles and methodologies. It is a right-brain didactive for those new to AEDP and a sophisticated demonstration of what Lipton and Yeung and Zhang describe as the hallmark of TP, when we “surrender to the improvisational emergent moment,” trusting that our left-brain knowing will chime in when we need it.

Lastly, this issue could not have been complete without an article on creating and maintaining Therapeutic Presence online in this new era of telehealth. For that, Carrie and I asked AEDP faculty members Natasha Prenn and Kate Halliday to summarize how they do what they do. Many of you have seen their YouTube videos. Here is a written account, with Prenn, in her brilliant and invaluable way of providing for AEDP therapists phrases to suit almost every clinical moment. In her delightful languaging of AEDP, she and Halliday suggest we practice these phrases so that they will come to us at the right time. Their article is truly a toolbox for creating Therapeutic Presence online.

As we go to press, I want to mention an article that appeared in the June 1, 2020 issue of The New Yorker: “The New Theatrics of Remote Therapy.” The journalist interviewed several psychoanalysts about their experiences in the “new normal” of seeing their patients online. It complements the article by Prenn and Halliday, as well as offering a perspective from the psychoanalytic community.

https://www.newyorker.com/magazine/2020/06/01/the-new-theatrics-of-remote-therapy

Finally, I want to acknowledge the enormous contribution of Carrie Ruggieri to this issue. She is associate editor of our AEDP Journal, and this is the first time we have worked together. She has made editing much easier, as we put our heads together to re-write sentences that we think better convey what these authors are trying to say (and take on the burden of cross checking their references). You can look forward to Carrie leading a listserv discussion of each article. In the last month, Carrie has been instrumental in reformatting the downloadable PDF version of each article. We think it gives our Journal a new layout that is more professional.

We hope the new look is also more readable. Please give us your feedback. We trust that everyone is staying safe, and somehow maintaining hope, in these extraordinary, surreal times.

Gil and Carrie