ABSTRACT
The reader may already have wondered this and might, I imagine, already have an answer. It is clear, in fact, that the therapist and the experience of therapy itself end up being positioned in the dominant semantics in the family conversation. It is impossible also in individual treatment for therapists not to position themselves in the semantics within which patients have learnt to place themselves in their families. If it is true that the patient's conversation with the family is organized around very different meanings, fuelled by specific emotions, as I have suggested in this book, then the therapist will also find herself taking a position, often unknowingly, in the dominant semantics when interacting with the client. This is confirmed by the results of a study we have carried out on the transcripts of the first two sessions with sixty patients (Ugazio et al., 2011). We do not, therefore, have a single way of building up the therapeutic relationship, but have as many different ways as the number of semantics. The therapeutic relationship is constructed distinctively by each semantic of freedom, of goodness, of power and of belonging. There are as many differences in the therapeutic alliance, the rifts created within it, the dysfunctional circuits, as the number of semantics that prevail. What I suggest is not just that patients with the four psychopathologies considered in this book construe the relationship in a particular way. Patients with psychopathologies other than the ones I have considered here, or with existential problems, if they belong to conversational contexts dominated by one of the four semantics I have described, will also construe the therapeutic relationship in a way more or less similar to other patients typified by these semantics. The crucial variable that shapes the therapeutic relationship is not so much the psychopathology but the dominant semantics in the patient's conversational contexts. Let us consider, by way of example, the very different positions in which therapists end up when the semantics of freedom or power are dominant.
