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Relational Cultural Theory

Angelica Castillo

Beginnings

  • RCT was first developed from the early work of Jean Baker Miller and was further developed collaboratively with Judith Jordan, Irene Stiver, and Janet Surry

  • They did not agree with traditional models that encouraged individualism and separation
  • power-over

  • Weakness as strengths

  • Giving voice to women and their unique experiences
  • "Listening to each other into voice"

Feminist

Humanistic

Developmental

RCT

Neuro-Relational

Constructivistic

Founders

  • Toward a New Psychology of Women (1976), “Women stay with, build on, and develop in a context of connections with others.”

  • "Monday Night Group" 1977
  • unique understandings of women they treated vs traditional clinical perspectives of women
  • the Stone Center Theory Group, Founding Scholars

  • Collaborative and supportive

  • Born in New York
  • Polio at 10 months of age
  • Died of complications of emphysema and polio
  • MD from Columbia University
  • 40+ years of clinical experience
  • psychiatrist and psychoanalyst
  • "Toward a New Psychology of Women" & "The Healing Connection"
  • Professor at Boston University & Harvard Medical School
  • Founder of the Jean Baker Miller Training Institute in 1995

Jean Baker Miller, M.D.

1927 - 2006

Judith Jordan, PhD

  • From Pennsylvania
  • PhD from Harvard University
  • Co-founder & co-director of the Jean Baker Miller Training Institute
  • Senior Scholar at Wellesley Center for Women (WCW)
  • Faculty at Harvard Medical School
  • Director of Training and Women's Studies at McLean Hospital
  • Women's Growth in Connection
  • Attended Abbot Academy
  • Homesick from family
  • Was told to separate from family in order to be "successful"

  • 30+ years of clinical and teaching experience
  • Director Emeritus of Psychology Department of McLean Hospital
  • "The Healing Connection: How Women Form Relationships in Therapy and in Life" and "Women's Growth in Connection"
  • Work inhibition in women
  • Dependency in relationships between men and women
  • Women's professional development and experience
  • Disconnection in troubled families

Irene Stiver, PhD

1924 - 2000

  • PhD from Harvard University
  • Buddhist dharma leader
  • Internationally known clinical psychologist
  • Taught at Harvard Medical School and Barre Center for Buddhist Studies
  • Insight Dialogue Teacher
  • Board member of Institute for Meditation and Psychotherapy
  • Women's Growth in Connection
  • We Have to Talk
  • Mother-daughter relationships, adoption, substance abuse
  • Boston & Costa Rica

Janet Surry, PhD

What do you think?

Case of Jane

Imagine you are supervising a CIT that has just been assigned a new client named Jane. Jane is a young working-class woman. Jane reported that she wanted therapy to help her with recent difficulties in concentrating and the subsequent problems she was having at her job. She thought her problems had something to do with the death of her mother, with whom she had been very close, over a year before. As the CIT explored Jane's thoughts about her mother's death, Jane became increasingly distraught and tearful. The CIT was very moved by Jane's story. Jane asked if it would be possible for her to come to therapy twice a week.

7 Fundamental Concepts

Overview

1) People grow through and toward relationships

  • Relationships are integral and inevitable

2) Mature functioning

  • Movement toward mutual empathy rather than separation
  • Able to see the impact they have on others and how others impact them and begin to change

3) Relationship differentiating & elaboration characterize growth

  • Openness to exploring various relational images
  • Differentiating between negative relational images and discrepant relational images (more positive or different expectations)

4) Mutual empathy and mutual empowerment

  • Core of growth fostering-relationships
  • Exploring & identifying relational interactions that are more empowering can foster emotional & relational growth

Key Concepts Continued

5) Authenticity is necessary

  • Individuals should feel as if they can be themselves without judgement

6) All people contribute & grow or benefit

  • everyone involved will experience positive outcomes

7) Relational competence & capacities are enhanced over the lifespan

  • Increase opportunities for constructive connections

*These concepts are used to:

  • re-negotiate relational disconnections
  • promote self-empathy
  • deconstruct relational images
  • examine power within the social context
  • improve relational resilience

Video

Relationships

  • All humans seek love and belonging

  • Healing is in the mutually empathetic, growth fostering relationships

  • We function best when in mutual, harmonious relationships

  • Necessity of conflict in relationships

Empathy

Our empathic resonance and responding help us to understand our common humanity

  • empathy is an important source of understanding our connectedness

We are born to connect; we are hardwired to connect

Bridge to healing - helps to combat isolation

Mutual Empathy

  • Understanding, feeling, knowing that we are impacting someone else and they are impacting us
  • Helps to correct power-over

Anticipatory Empathy

  • predictions about how you will impact the other person
  • attitude of understanding and intentionality

Self-Empathy

  • Self-compassion

In a connected, growth-fostering relationship:

5 Good Things

1) A sense of zest

2) Increased knowledge of oneself and the other person

3) Increased sense of worth

4) Ability and motivation to take action in the relationship, as well as outside the relationship

5) A desire for more connection

Amy Banks, M.D.

Neuroscience

  • M.D. from Georgetown University
  • Senior Scholar at Wellesley Centers for Women
  • Director of Advanced Training at JBMTI
  • Instructor of psychiatry at Harvard Medical Center
  • First to merge RCT and neuroscience

Neuroscience helped get RCT recognized and accepted by others

4 Neurological Pathways/4 Ways to Click

1) Smart Vagus Nerve

  • Healthy relationships fuel our autonomic nervous system and help us to feel calm & happier
  • As simple as looking at someone and smiling

2) Anterior Cingulate Gyrus

  • Pathway that lights up for physical pain
  • Same exact pathway lights up for social pain
  • Social Pain Overlap Theory (SPOT)

3) Mirror Neurons

  • A system/network of nerve cells in our brain that bring in sensory information to help us immediately read the actions, intentions, and feelings of others
  • Rubbing hands together

4) Dopamine Reward System

  • Nurture, food/water - stimulate dopamine
  • When we take nurturance out, we look to other things to get that dopamine

Relational Science

1) Relational Cultural Theory

2) Neuroplasticity

  • use it or lose it
  • neurons that wire together, fire together

3) Relational Science

Relational Assessment

  • how your relationships affect your brain & how your brain affects your relationships

*In a bad relationship, pathway for stress & anxiety get stronger

  • ranks your relationships into 3 safety groups
  • high, moderate, low
  • relational dilution

Calm - Smart Vagus Nerve

Accepted - Anterior Cingulate Gyrus

Resonant - Mirror Neurons

Energetic - Dopamine Reward System

C.A.R.E. Program

Nature of Malajustment

Disconnection

Central Relational Paradox

Isolation, Shame, Disappointment

Disconnection

Strategies of Disconnection

What if the culture itself is an active agent of disconnection?

Disconnection: not being understood or not understanding the other person - no mutual empathy

  • isolation, shame, disappointment

Isolation = suffering

Chronic disconnection: repeated disconnections in the relationship

  • may be linked to power in a relationship
  • may lead the individual to unhealthy strategies to fit into the disconnected relationship

Strategies for disconnection: methods used to protect relationships, however, they avoid authenticity

Central Relational Paradox: looking for belonging and connection, but this yearning leads to vulnerability

  • may lead the individual to hide parts of themselves in order to avoid disconnection

Goals of Counseling

  • Change negative self images
  • move out of perceived isolation reduce chronic disconnection

  • Model a positive relationship

  • Transform Disconnections
  • Broaching culture
  • Challenging negative relational images

Change

  • Collaborative & supportive

  • Focus on relationship

  • Counselor should display authenticity & presence, even when disconnection occurs

  • Mutual empathy & mutual engagement is key

  • Counselor should have awareness of own relational images, as well as those of their clients

  • Counselor should help client to conceptualize within the broader social and cultural context

Role of Counselor

Interventions

  • Mutual empathy

  • Fluid expertise

  • Anticipatory empathy

  • Therapeutic empathy

  • Relational images

  • Broaching culture

  • Modeling

  • Goal setting

C.A.R.E. Relational Assessment

C.A.R.E. Assessment

https://amybanksmd.com/CARE/

Implications

  • Research has been limited, but it growing

  • Social Advocacy component

  • Evidence based

  • Limitations include
  • time constraints - RCT is a long-term approach; termination is often discouraged
  • limited research on inter-gender work
  • supervision may be difficult if theory is not understood and practiced by supervisor
  • unlikely to stand alone, may need to be paired with other techniques (SFBT, Narrative, Gestalt, DBT)

Gwen is a 56 year old, married African American mother of 4 adult children. Gwen has been married to Ron for 31 years and describes their relationship as supportive. Gwen is the oldest of 5 children and had to take on the responsibility of caring for her younger siblings at a young age. She presents with fibromyalgia, difficulty sleeping, and a history of anxiety and depression. She reports feeling stressed and isolated at her job and is having a difficult time managing her multiple roles.

Case Study

  • What contextual factors stand out to you?

  • What misconceptions might a counselor make about the client if they do not take into consideration any contextual or cultural factors?

  • What RCT strategies may help you if you were client's counselor?
  • Unlike other theories, RCT fills the multicultural gap by specifically operationalizing how counselors can use therapeutic alliance to examine & enhance current relational interactions with culturally diverse clients

  • Allows counselors to address relational concerns, take a we perspective, and help clients of color address issues related to a systemic marginalization

Multicultural Considerations

Future of RCT

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