Similarities, dissimilarities, and blind spots in therapeutic relations

Mor Shechory-StahL PhD

But one’s own must be learned as well as that which is foreign

Hölderlin

In their choices and lives, people are influenced by dimensions of similarity and dissimilarity or strangeness between themselves and their surroundings. Observation of social groups reveals that communities emerge on the basis of similarity. Usually similarity elicits good feelings, a wish to approach and get to know, to imitate or even to identify, a sense of security and trust in the other. Experiences of dissimilarity, by contrast, are likely to trigger feelings of incomprehension, criticism, insecurity, suspiciousness, and a wish to keep away (Del Rio, 1984). The sociological term homophilia (love of the similar) refers to humans’ tendency to attach themselves to those who resemble them, those with whom they share beliefs, values, education, etc. Psychoanalytic theory already refers to fear of the different, and the need for closeness to the similar, in Freud’s 1919 paper on the “Uncanny,” where he discusses the semantics of the German adjective heimlich - familiar and intimate - and its opposite unheimlich, denoting the uncanny, or strangeness. Freud writes: “the uncanny is that class of a frightening which leads back to what is known of old and long familiar.” Self psychology explains this need for similarity and intimacy. Heinz Kohut wrote that one need of the self is the need for “twinship,” the need to be in a relationship with a similar person: someone with whom one feels there is a common denominator, who gives a soothing sense of belonging and prevents feelings of nonbelonging and loneliness (Kohut, 1971).

Though much has been written about the therapeutic relationship, on the subject of similarity and dissimilarity as it occurs between therapist and patient and affects their relationship there is hardly any published work at all. Theoreticians of psychoanalysis nevertheless suggested early on how the subjective person and real components of the therapist - such as gender, ethnicity, external appearance, personal history, and psychological elements - affect both transference and countertransference, and currently theoreticians stress the centrality of the therapist’s subjectivity in the therapy. But in spite of significant theoretical work in this field, there is a need for more in-depth and specific elaboration of the subjectivity and intersubjectivity emerging from similarities and dissimilarities in the therapeutic dyad.

 
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