IJSP Number 4, 2022

42 of the therapist. These unequal starting conditions lead to further characteristic aspects in practice: the therapist can ask, judge, prompt, criticize, encourage, reject, and refuse the patient. In principle, this also works the other way around, but in the patient ’ s experience, these characteristics of an active and controlling relationship are more likely to be located with the therapist, at least in the initial phase of therapy, especially because of the different starting conditions of the help-seeker and the helper described above. In addition, there is the flow of money from the person seeking help to the helper with corresponding requirements and demands on the helper in terms of training and certification, which reflects not only an economic and legal factor, but in essence a debt settlement: the knowledge of payment relieves the person seeking help in this respect. On the one hand, this shows how much real problem potential and which tensions are hidden in this constellation, even beyond an analysis of the therapeutic relationship in the narrower sense of a psychodynamic event. On the other hand, it is precisely this constellation of being mutually dependent on each other that forms the basis for the further development of the therapeutic relationship. 5. Working together in therapy It is not the case that the supportive flows quasi like a medicine from the helper into the person seeking help, but the idea of therapy is (outspoken or unspoken) that collaborative work is done increasingly over the course of therapy. In other words, both throw their skills into the balance and work together to improve the situation for the patient. For severely traumatized, deeply depressed, highly anxious patients, this is a complex challenge and a high demand. To be able to deal with this and to move the patient to a creative cooperation despite her stresses is certainly part of the therapeutic art (here we refer to Metzger ’ s characteristics of working with living beings and processes: described by Metgen [9] e.g. in Walter [10], Kriz [11], Kästl [7], Stemberger et al. [12, 13, 14, 15]). In principle, a dynamic development in therapy will usually take the form of the patient working shoulder to shoulder, so to speak, with the therapist on the problems. Both are united by the task of therapy to bring about an improvement in the patient ’ s situation. The therapeutic constellation successively induces a change in the patient ’ s perspective: She initially experiences herself primarily as a suffering person whose task is to describe her suffering and the situation from which she suffers and to make it accessible and understandable to the therapist. The therapist tries to empathize and think herself into the phenomenal world of the patient. This process is accompanied by communication, both exchange what they see and feel and make sure that, if and how their view of the patient ’ s experienced world matches sufficiently. If this succeeds, the patient will feel “ seen ” and unders tood. However, this process is not a one-sided procedure, even if the focus of attention of both participants is naturally directed to the experienced world of the patient. For the patient will also engage with what she experiences of the world of the therapist, and ideally precisely in relation to the parts of that which become “ visible ” to the patient in the course of therapy: Namely, the specific way of encountering the patient, what the therapist emphasizes in the process, in which language that was is