Difficult dyads: Understanding effective and relational components from anintersubjective perspective

An intersubjective perspective suggests that the therapeutic process consis ts of a dynamic interplay between the two participants. Clinicians, like cl ients, have relational needs. When their legitimate need to relate to anoth er person is rejected and/or when the need to feel significant is undermine d: the worker, er may feel helpless, hopeless, or nonexistent. Vignettes fr om the crucial beginning phase are used to illustrate how rite clinician's feeling states may contribute to difficult treatment situations. Strategies for managing feeling states and enhancing tolerance are proposed. The pape r demonstrates how such strategies may facilitate the treatment process.