Presence is an expression of our full internal and external contactfullness, it communicates our dependability and our willingness to take responsibility for our part in whatever happens in this unique therapeutic relationship (Erskine, Moursund & Trautmann, 2023) Presence includes receptivity to our client’s affect: our willingness to be influenced by our client’s emotions, to be deeply moved while not becoming emotionally overwhelmed.

An essential component of  presence lies in the question, “What is the impact of my affect and behaviour on my client?  Presence occurs when our behavior and communication, at all times, respects and enhances the integrity of the client. At times my eyes have filled with tears or I have felt a protective anger when I hear about the neglect or abuse my clients suffered in their young lives.
 
There is a duality to presence that entails our simultaneous attention to our client and to ourself. Presence flourishes when we temporarily decenter from our own needs, feelings, fantasies, or desires and make the client’s process our primary focus; but, paradoxically, we must not lose awareness of our own internal process, our resonance, and our reactions. Our personal history, relational-needs, sensitivities, theories, professional experience, own psychotherapy, and reading interests all shape our unique reactions to every one of our clients — these are the essential parts of therapeutic presence. 
 
Each psychotherapist has a unique set of past experiences, current interests, needs, and wants. We have our preferred theories, concepts, and methods, and we use our experience as a kind of reference library that helps us attune to our clients and to understand how they function. Importantly, presence includes our willingness to be transparent in our uniqueness, willingness to let our clients see who we are and what we are experiencing, willingness to be impacted by that which is significant to our client, and a willingness for that impact, too, to be seen.
 
Presence provides a container for our therapeutic involvement, an interpersonal safety net that supports without constraining and protects without demeaning the client. More than just verbal communication, “presence” describes a communion between us and our clients. It is the basis of a healing relationship. The respectful interplay between our self-awareness and decentering opens the way for what Martin Buber (1958) calls an “I-thou” relationship, an involved relationship between two connected, contactful, self-and-other-aware individuals. The “I-thou” relationship, in turn, is the primary source of the transformative potential of Relationally-focused Integrative Psychotherapy.
 
From a classic psychoanalytic perspective the concept of “involvement” violates the principal of therapeutic neutrality.  For several decades the task of the psychoanalyst was to remain a blank screen, with evenly-hovering attention (Freud,1912; Greenberg, 1986).  For the psychoanalyst to provide the client with more than a reflecting mirror was considered to be a therapeutically disruptive counter-transference (Poland, 1984). 
 
From the perspective of a Relationally-focused Integrative Psychotherapy   involvement is one of the essential dimensions of an authentic, person-to-person relationship. A central premise of a relationally-focused psychotherapy is that “effective healing of psychological distress and relational neglect occurs through a contactful therapeutic relationship — a relationship in which the psychotherapist values and supports vulnerability, authenticity, and inter-subjective contact” (Erskine, 2021a, p. 212).
 
Therapeutic involvement begins with the psychotherapist’s commitment to the client’s well-being, an unwavering awareness that the client, and what they need in a therapeutic relationship, is most important (Erskine & Moursund, 2022)  This commitment is the bedrock that makes an authentic involvement possible. The involved psychotherapist is with-and-for the client, fully contactful — honest and willing to put energy and effort in helping clients achieve their goals.  When we are fully committed to the client’s welfare our involvement enriches the client’s vitality and helps the client form a secure sense of self. Involvement is what makes relationship vibrant — two people exchanging ideas and feelings, each challenging and enhancing the authenticity of the other.
 
Involvement emerges from the psychotherapist having a genuine interest in the client’s intrapsychic and interpersonal worlds and then communicating that interest through attentiveness, patience, and respectful inquiry.  When I am fully involved, I am vulnerable; I allow myself to me emotionally touched. I strive to let my caring for the client show by being curious, tender, and respectful. My involvement has to do with my commitment to being an active, caring, vulnerable, and authentic participant in the therapeutic process.  Our involvement is reflected in our acknowledgement, validation, and normalization of what the client presents as well our willingness to be known.  Involvement has more to do with being than doing (Erskine, 2021b).
 
Involvement is about the therapist-client interchange. It is about us, the psychotherapist: how we feel, think, and respond to the client. And, involvement is about the client: how they perceive our investment with them and how we are impacted by what happens in the relationship.  Involvement is about the inter-subjective interplay between us — the dance of interpersonal contact. Involvement is best understood in terms the client’s perception: their sense that the therapist is attending to their relational-needs and truly committed to their welfare. 
 
When we psychotherapists identify and resonate with our clients -- when we are fully aware of our reactive countertransference and make therapeutic use our responsive countertransference -- we create an intersubjective process of two people sharing an intimate experience together. The important aspects of psychotherapy are embedded in the distinctiveness of each interpersonal relationship, not in what we consciously do as a psychotherapist, but in the quality of how we are in relationship with the other person. Our attitudes and demeanour, the qualities of our interpersonal relationship, and the authenticity of our intersubjective connections are central in creating an effective psychotherapy. Presence and involvement are the essential ingredients of a healing relationship. 
 
Richard G. Erskine, PhD, has been the Training Director at the Institute for Integrative Psychotherapy in New York City and Vancouver, Canada since 1976. He is the author of a dozen books on the theory and methods of psychotherapy. He currently serves as Professor of Psychology in the Faculty of Health Sciences, Deusto University, Bilbao, Spin, where he has developed the curriculum for a Postmasters degree in Integrative Psychotherapy. Some of his articles are available on the website  www.IntegrativeTherapy.com

References

Buber, M. (1958). I and Thou (R. G. Smith, Trans.). Scribner.
 
Erskine, R. G. (2021a) Early Affect Confusion: Relational Psychotherapy for the Borderline Client. nScience Publishing.
  
Erskine, R. G.(2021b). A Healing Relationship: Commentary of Therapeutic Dialogues. London: Phoenix Publishing. 
 
Erskine, R.G. & Moursund, J.P. (2022). The Art and Science of Relationship: The Practice of Integrative Psychotherapy. Phoenix Publishing.
 
Erskine, R.G., Moursund, J.P. & Trautmann R.L. (2023). Beyond Empathy:  
A Therapy of Contact-in-Relationship. Rutledge Mental Health Classic 
Editions.
 
Freud, S. (1912/1958) Recommendation to physicians practicing psychoanalysis. The standard edition of the complete psychological works of Sigmund Freud (Vol. 7, pp.109-120. Hogarth Press. (Original work published 1912)
 
Greenberg, J. R.  (1986) Theoretical Models and the Analyst's Neutrality. ContemporaryPsychoanalysis, 22:1, 87-106. doi: 10.1080/00107530.1986.10746117
 
Poland, W. (1984).  On the analyst's neutrality.  Journal American Psychoanalytic  Association, 32: 283-299. https://doi.org/10.1177/000306518403200203