I agree that I think it takes a very strong T to undertake this kind of work with a client. My T is so accepting of things that I bring, my pushes and pulls, my criticism, my desires and of me I suppose. She accepts gifts that I make, she listens to my complaints about her and our therapy, telling me straight (mostly) why she does the things she does and accepting and apologising if she made a mistake. I, in turn, do likewise. She sits with me through many silences but also comes up with ideas to get me moving again if I can't do that on my own. She seems just as happy to sit and play with me as she does to have a proper conversation about day to day things that affect my life, or the deep stuff surrounding the past. She has given me pieces of herself, without burdening me with information and has never once given me any promises that she didn't feel she could keep, either short term or long term (oh except once early on and it took several weeks to work through that one, but she was there, consistent and steady as ever. She apologised and said she had learnt a very valuable lesson).

I said it takes a strong T, not a skilled T, because I must admit that I think that I am the first adult that she has worked with in this way. We have never discussed attachment issues but I think I have them, along with a while host of other issues such as not attaching to my Mother as a baby, with a father who worked away, CSA, emotionally neglecting parents, a mother with chronic depression as I was growing up, childhood bullying, fairly severe drug addictions and the fact that I may be on the autistic spectrum. Trying to decide which of these issues causes what is almost impossible to be honest and I think that my T doesn't like to try to look for cause and affect too much, but just works with whatever I bring at the time.

The reason I say that I think that I am the first person the has worked with in this way is mainly because she said that she had never had the issue of out if session contact come up before and I can't imagine doing this work without it. I could be completely wrong though, and it has been a question I have been wanting to ask for a long time. For me the out of session contact helps massively because I do have a real problem in talking during therapy and without the ability to write down my thoughts and reflections, our entire sessions would be largely based around what came up for me from the one before, and that wouldn't be very productive.

So strong, not necessarily skilled, in my opinion.

I also believe that it takes a client who is in the right place themselves, and that is even harder to define than it is to define a good or strong T.

I also believe that the relationship has to be right, and it could not be a good fit between the two. If it is not, then I don't think this type of work would be effective and I think it could be very harmful.

I think Ts should be upfront about the possibility of therapy not helping, and that, in some circumstances it may not work out between the two and that, in those instances, the T would try to find someone else more suitable for the client to work with. I think a lot of people would see this as abandonment but in my heart I do not believe that it is. It is a fact of life that some peoples psyches do not gel but it is inprative that a T spot this early on, does not lead the client on in the hope that they can 'make it work'. It is an art form not a science and each output will be different, that is the nature of the beast and that is what should be explained to the client.