ABSTRACT
We have highlighted the importance of the therapist attuning empathically to the client, both as a ®rst priority and as support for the development of the therapeutic alliance, but also as a potential healing factor in and of itself. Research studies have consistently demonstrated the relationship between empathic attunement and outcome (for a useful review see Bohart et al., 2002). The question then arises about how this process is best engaged within the dyad. As we have seen, implicit relational exchanges are key in this process, as are body-based communications that do not necessarily need to be re¯ected in the use of verbal exchanges between therapist and client. There is also the complexity of what constitutes the empathic experience, which might involve the therapist not only getting inside the skin of the client, as it were, but also getting inside the skin of the relationship (O'Hara, 1984). This could mean that the therapist might on occasion be more empathic by seeming unempathic, for example, where noticing and commenting on a client's affective state might be intrusive. We all have experience of such situations, particularly with clients who are not able to name their emotions and where these are located so far out of conscious experience. Under those conditions, the therapist needs to be extremely sensitive and not jump in with responses such as `I can see how sad you feel', thus highlighting the client's inability to actually consciously experience such a feeling.
