Working at ‘Relational depth’

• Term coined by person-centred

Relational Depth therapist, Dave Mearns, in 1990s

• Developed by Mearns
and Cooper (2005):
Mick Cooper
Professor of Counselling Working at Relational
University of Roehampton Depth in Counselling
mick.cooper@roehampton.ac.uk
and Psychotherapy
Special thanks to all colleagues who contributed work to this
presentation:
(Sage)
Ambika Erin Connelly, Anne Deacon, Shiri Gurvitz, Rosanne Knox,
John Leung, Gina Saskjia Di Malta, Eleanor MacLeod, Gillian Morris,
David Murphy, Aisling Treanor, Sue Wiggins

‘Relational depth’
Research, theory and
practice developed in
Knox, R., Murphy, D.,
Wiggins, S., & Cooper,
M. (Eds.). (2013).
Relational depth: New
perspectives and
developments.
Basingstoke: Palgrave.

Definition of Relational Depth Closely related concepts

‘A state of profound • ‘Dialogue’/’I-Thou
contact and engagement attitude’ (Buber)
between two people • ‘Dialogue’ (Bohm)
in which each person is • ‘Moments of meeting’
fully real with the Other, (Stern)
and able to understand • ‘Mutual intersubjectivity’
(Jordan)
and value the Other’s
experiences at a high • ‘Co-presence’ (Laing)
level’ • ‘Linking’ (Rowan)

(Mearns and Cooper,

2005, xii)

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 Should we be No
‘I’m quite happy for it to be

studying elusive. There's a fear of–

it’s like kind of butterfly
catching, isn’t it? – there’s
catching
a fear of catching
relational something very beautiful
and trying to define what
it is. And then- and in
depth? that process, losing what it
is.’ (participant in
Connelly, 2009)

Yes
• Research and exploration
does not need to be
What is the
experience of
definitive, can be
exploratory
• Can be one of several
means of finding out
more
relational
• Willingness to challenge
assumptions and be open
to world and learning
depth like?

Four Components of RD Intrapersonal: Present

• Exhilarated, empowered, revitalised, alive
Experience of
Intrapersonal • Immersed, free of distractions
other • Authentic, real, open
• Spontaneous, in the moment
Relational
• Feeling OK with self, self-worth, safe
depth • Understanding, accepting of Other
• Satisfied
Relational Atmosphere • Physical, embodied, electrifying, tingly
• Insight
Source: Cooper, 2005; Cooper, 2013; Connelly, 2009; Knox, 2008, 2011; Macleod, 2013; Morris, 2009, 2012

2
 Experience of Other: Open Relational: Connectedness
• Closeness, intimacy, togetherness
• Other as genuine, authentic, real • Love
• Encounter, meeting of minds
• Other as understanding • Flowing together, synchronicity
• Other values, acknowledges, • Bi-directional, reciprocal
• Blending, at one-ness, union
accepts me • Mutuality, equality
• Trust
• Respect, empathy for other
• Interconnectedness: ‘I know you know I know…’

Atmosphere: Transcendent
• Timelessness Is it possible to
• Magical
• Still
‘operationalise’
• Altered state
• Spiritual
relational
• Powerful depth?

Relational Depth Inventory (Wiggins, 2012)

Measures of relational depth Depth of specific moments of relating
• Three measures of relational depth now established:
– Relational Depth Inventory (Wiggins, Elliott & Cooper, 2012; n =
342)
– Relational Depth Frequency scale (Di Malta, 2016; n = 434)
– Relational depth content analysis (Wiggins, Elliott & Cooper, 2012; n
= 342)
• All show excellent inter-item/inter-rater reliability: α = .93-
.98; ICC = .79; with one main factor
• Good convergent validity with the Working Alliance
Inventory (correlation = .33-.77)
• Indicates that depth of relating is a measurable,
unidimensional phenomenon; related to (but not identical
with) the therapeutic alliance

3
 Relational Depth Frequency Scale (Di Malta, 2016)
Frequency of moments of deep connection
Relational Depth Content Analysis (Wiggins et al, 2012)
Coding of qualitative descriptions of significant moments
Level 3 (RD ‘clearly present’)
E.g., ‘There was an interpersonal connection in the moment and my perceptual
awareness changed.’

Level 2 (RD ‘probably present’)

E.g., ‘A session where I was able to be myself as a small child and to gain the
ability to comfort myself without feeling embarrassed by the process and where I
felt emotionally held by the therapist.’

Level 1 (RD ‘probably not present’)

E.g., ‘This situation was a setting about the structure of my family. We did body
therapy and I had to assemble the different persons and their relations to myself
and each other’.

Level 0 (RD ‘clearly not present’)

E.g., ‘I did not feel I was connecting with this client at all.’

Do therapists Quantitative Findings

• 97.9% of therapists reported some experience of

experience RD (n = 140, Leung, 2008)

• Therapists’ mean ratings on Relational Depth
Frequency Scale = 3.7 (Di Malta, 2016): e.g., ‘I
relational depth experienced an intense connection with [the
client]’

with their 1 = Not at all 2 = Only occasionally 3 = Sometimes 4 = Often 5 = Most or all of the time

clients? • In 38% of therapists’ significant events, RD

rated as ‘probably’ or ‘clearly’ present (Wiggins,
2012)

Qualitative Findings Moderators

• 100% person-centred therapists could identify one • More experienced 4

or more experiences of RD (Cooper, 2005) therapists, and qualified

therapists (cf. trainees)
90% of therapists working with learning disabled
clients had experienced RD (Macleod, 2013) report more experiences
of RD
Frequency of RD

• Therapists report more

RD in longer episodes of
therapy
• Therapist gender,
orientation, age – no
significant differences
(Leung, 2008; Di Malta, 2016) 3
<6 sessions 6-24 sessions >24 sessions

4
 Do clients Quantitative Findings
• 78.2% of clients reported some experience of RD (n =

experience 119, Leung, 2008)

• Clients’ mean ratings on Relational Depth Frequency
Scale = 3.4 (n = 220, Di Malta, 2016)

relational depth 1 = Not at all 2 = Only occasionally 3 = Sometimes 4 = Often 5 = Most or all of the time

with their • Both studies suggest clients report RD significantly less

than therapists
• In 34% of clients’ significant events, RD rated as

therapists? ‘probably’ or ‘clearly’ present (Wiggins et al., 2012)

• Therapists rate greater depth of relating at significant
moments of therapy (d = .52, Wiggins et al., 2012)

Qualitative Findings Young people’s experiences

• ‘Most participants of the research [n = 26] were able to identify at least one
Young people
moment they felt could be described as a moment of relational depth’ (Knox, struggled to identify
2013)
• All participants in Cognitive Analytic Therapy could identify moments of particular moments of
relational depth (n = 6, Morris, 2012)
• …However, ‘many also spoke of having experienced several therapeutic
‘connection’ and
relationships in which they felt there had been no moments of relational depth’. ‘closeness’ with their
therapists
(but could identify
important moments in
therapy: primarily
significant disclosures)
(Gurvitz, 2016)

Moderators: Orientation Moderators: Gender

Mixed findings regarding • Clients with female therapists tend to
orientation, but some experience a greater frequency of RD (Di
evidence that greater RD in Malta, 2016), and also rate a greater depth
humanistic/person-centred of connection (Cooper, 2012), as compared
approaches with male therapists
(Leung, 2008; Di Malta, 2016)
7
100
Percentage reporting RD

Female therapist
Depth of connection

80
6.5

60
6
40

20 5.5 Male therapist

0
Hu
m
Ps
yc
Ot
he
5
an ho r
ist
ic
dy
na Female client Male client
m
ic (Cooper, 2012)

5
 Client Client

Do clients and Therapist

Depth of connection
therapists
experience
relational depth
?
at the same time?
Time

‘Analogue’ study (Cooper, 2012) Results

• 20 min ‘counselling’ sessions
• In situ ratings: Participants asked to rate level
of contact every minute during session
• Therapists’ ratings significantly predicted
clients’ ratings
• Mean correlation: .67 = approximately
45% overlap in ratings

therapist client
rating of rating of
depth depth

Maximum matching Minimum matching

Client Client

Therapist Therapist

6
 Relational depth and outcomes
What is the Clients invited to
identify a particularly
helpful moment in

effect of an therapy, and rate on

depth of relating
using the RDI

encounter at
(Wiggins, 2012)
Then compared
against therapeutic
outcomes

relational Results
Depth of relating very strong predictor of

depth? outcomes
Accounting for 10-30% of outcomes

RD-Outcome correlation (Wiggins, 2012) Subjective Ratings

‘To what extent do you think that these
moments of relational depth have had an
enduring impact?’ (online survey, Leung, 2008)
More improvement

Extremely 7

5
Clients
4
Therapists
3

Not at all 1
More depth

Qualitative Interviews Immediate effects (Knox, 2008)

Moments of relational depth ‘were seen by
participants as highly significant with an enduring
positive effect, both on the therapeutic process and
long after the therapy had ended.’ (Qualitative
interviews, Knox, 2008)
• Moments experienced as facilitative, healing and changing
• Positive effect on the therapeutic process itself:
– deepening and equalisation of relationship
– greater trust in therapist
– Increasing openness to verbalise innermost feelings
– Feeling able to return to moments of in-depth contact again

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 Long term effects (Knox, 2008)

• Increased sense of connection to their own selves (85%)

– greater self-knowledge and self-understanding
– enhanced self-acceptance
– greater ability to be their ‘real selves’
• Feel more able and powerful (80%)
• Improved relationships with others (50%)
Disconnection
and distress

The distress of disconnection The distress of disconnection

• From relational perspective, experience
of chronic disconnection from others is
the primary source of psychological
distress
• I.e., clients’ psychological difficulties
often related to problems establishing
in-depth connections with others, or
lack of experiencing such relationships
• Loneliness = lack of intimacy and closeness
• Depression = lack of interpersonal pleasures;
sadness at lack of relating; less buffer against
psychological stressors; isolation and being outside
of community
• Anxiety = being without support
• Interpersonal problems = unsatisfactory/frustrating
/enraging/untrustworthy relationships; inability to get
what one wants from relationships
• Psychosis = internal splitting to replace external
relationality

Relational developmental theory: Why

do people become disconnected?
• Infants have innate need/capacity to connect with
What facilitates
Others
• Where attempts to connect
unsatisfying/painful/abusive/frustrating…
a meeting at
• Infant develops strategies of disconnection (Jordan
et al., 2004) to protect self: e.g., mental
withdrawal, inauthenticity, aloofness
relational
• Strategies become chronic and automatic, so
deployed in adult life where deeper relatedness is
a possibility
depth?

8
 Therapist Factors Therapist Factors
‘It felt as though my counsellor, without breaching
– Genuinely caring/ boundaries, went beyond a professional level/interest – and
offering something A lovely, gave me such a human, compassionate response –
‘over and above’ compassionate something I couldn’t put a price on… I think I had only
expected to receive from her professional self…. [I]t felt like
– Competent/safe/ person she was giving from her core.’
trustworthy
– Warm (vs.
cold/distant)
– ‘Really’ real
– Open and
adaptable
(Client interviews: McMillan and McLeod, 2006;
Knox, 2008; Knox & Cooper, 2010)

A Relaxed Warmth Client Factors

• Therapists’ perceived “neuroticism” seems to – Know what they want
inhibit deepening of connection (Cooper, 2012) from therapy
– Considered choice of
therapist
– Be ready to engage
– Choose to relate at
depth, Make leap of
faith
– Open up to therapist,
allow self to be
vulnerable
(Client interviews: McMillan and McLeod, 2006; Knox and
Cooper, 2011)

Client Factors
“[I]t was a very definite thing within myself, that
happened, that I allowed myself be so open, and let How might
my defenses down enough…it was almost as if, I’d got
to the point…of no return and I thought, ‘I’m going
to go for it.’”
therapists be more
open to meeting
clients at relational
depth?
Source: Knox and Cooper, 2011

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 Thank you
mick.cooper@roehampton.ac.uk
@mickcooper77 CREST Roehampton Key references
• Cooper, M. (2005). Therapists' experiences of relational depth: A qualitative interview study. Counselling and
Psychotherapy Research, 5(2), 87-95.
• Cooper, M. (2012). Clients' and therapists' perceptions of intrasessional connection: An analogue study of
change over time, predictor variables, and level of consensus. Psychotherapy Research, 22(3), 274-287.
• Jordan, J. V., Kaplan, A. G., Miller, J. B., Stiver, I. P., & Surrey, J. L. (Eds.). (1991). Women's Growth in
Connection: Writings from the Stone Centre. New York: The Guilford Press.
• Knox, R. (2008). Clients’ experiences of relational depth in person-centred counselling. Counselling and
Psychotherapy Research, 8(3), 118-124.
• Knox, R., & Cooper, M. (2010). Relationship qualities that are associated with moments of relational depth:
The client’s perspective. Person-Centered and Experiential Psychotherapies, 9(3), 236-256.
• Knox, R., & Cooper, M. (2011). A state of readiness: An exploration of the client’s role in meeting at relational
depth. Journal of Humanistic Psychology, 51(1), 61-81.
• Knox, R., Murphy, D., Wiggins, S., & Cooper, M. (Eds.). (in press). Relational depth: Contemporary
perspectives. Basingstoke: Palgrave.
• Leung, J. (2008). A quantitative online study exploring the factors associated with the experience and
perception of relational depth. Doctorate in Counselling Psychology DPsych. dissertation, University of
Strathclyde, Glasgow.
• McMillan, M., & McLeod, J. (2006). Letting go: The client's experience of relational depth. Person-Centered
and Experiential Psychotherapies, 5(4), 277-292.
• Mearns, D., & Cooper, M. (2005). Working at Relational Depth in Counselling and Psychotherapy. London:
Sage.
• Wiggins, S. (2012). Development and validation of a measure of relational depth. PhD dissertation, University
of Strathclyde, Glasgow.
• Wiggins, S., Elliott, R., & Cooper, M. (2012). The prevalence and characteristics of relational depth events in
psychotherapy. Psychotherapy Research, 22(2), 139-158.
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