Relational Therapy: What it is and how it works
There's a particular kind of suffering that comes from feeling unseen—from moving through life carrying experiences, fears, and longings that no one seems to truly understand. You might have relationships, even close ones, yet still feel profoundly alone. Or perhaps you find yourself repeating the same painful patterns, wondering why connection feels so difficult or why certain dynamics keep showing up in your life.
If you're exploring therapy options, you've likely encountered various approaches and theories, each with its own language and methodology.Relational therapy is one such approach that incorporates both specific, attachment-based techniques and a fundamental understanding of how healing happens.At its core, relational therapy recognizes something essential: we are wounded in relationship, and we heal in relationship.
Confused About Relational Therapy?
The landscape of psychotherapy can feel overwhelming. There are countless modalities, each with its own terminology and focus. You might see terms like "relational psychotherapy," "relational psychodynamic therapy," "relational-cultural therapy," or simply "relational approach" and wonder whether these all mean the same thing, or how they differ from other therapeutic models you've encountered.
This confusion is understandable. Unlike approaches with highly structured protocols—like Cognitive Behavioral Therapy with its clear worksheets and homework, or EMDR with its specific phases—relational therapy is more of a philosophical orientation. It's a way of understanding how people develop, what causes psychological suffering, and what creates the conditions for healing.
Different therapists may integrate relational principles into their work in various ways. Some practice relationally-informed psychodynamic therapy, others combine relational approaches with somatic work or parts-based models like Internal Family Systems. What unites these various applications is a central belief: the therapeutic relationship itself is not just the context for healing—it is the primary mechanism through which healing occurs.
This can sound abstract at first. After all, don't all therapists have a relationship with their clients? Yes, but relational therapy places this relationship at the very center of the work. It's not simply a pleasant backdrop against which techniques are applied. The relationship—what happens between you and your therapist, how you affect each other, what gets activated, what patterns emerge—becomes the most important therapeutic tool.
If you're someone who has tried therapy before and found it helpful but somehow incomplete, or if you've worked with a therapist who seemed skilled but emotionally distant, relational therapy might offer something different. If you sense that your struggles aren't just about changing thoughts or behaviors but about something deeper in how you connect with yourself and others, this approach may resonate.
What is Relationally Focused Psychodynamic Therapy?
Psychodynamic therapy has a long history, stretching back to Freud and evolving significantly over the past century. Early psychodynamic work emphasized the therapist as a neutral, detached observer who interpreted the patient's unconscious material. The therapist was meant to be a blank screen onto which the patient projected their internal world.
Relationally focused psychodynamic therapy represents a significant departure from this earlier model. It emerged from a recognition that the therapist is never truly neutral or objective. You bring yourself into the room, and so does your therapist. Both of you have histories, vulnerabilities, reactions, and patterns. The therapeutic relationship is co-created—what unfolds between you is influenced by both people, not just by the client's projections.
This approach draws from multiple theoretical traditions: object relations theory, self psychology, attachment theory, and interpersonal psychoanalysis. What these share is an emphasis on relationships as central to human development and psychological well-being. We develop our sense of self in relationship with early caregivers. Our capacity to regulate emotion, to trust, to feel worthy, to connect authentically—all of this is shaped by our relational experiences, particularly in childhood.
When those early relationships were inconsistent, neglectful, or harmful, we develop adaptive strategies to survive. We might learn to minimize our needs, to hypervigilate others' emotions, to keep people at a distance, or to please others at the expense of ourselves. These strategies made sense given what we experienced, but they often continue into adulthood even when they no longer serve us, creating the very isolation or conflict we're trying to avoid.
Relationally focused psychodynamic therapy works with these patterns not by simply pointing them out, but by allowing them to emerge within the therapeutic relationship itself. The way you relate to your therapist—how you approach vulnerability, how you handle conflict or disappointment, what you assume about their feelings toward you—often mirrors patterns from your earlier relationships and your current life.
The difference is that in therapy, these patterns can be noticed, explored, and experienced differently. Your therapist pays attention not only to what you say but to what happens between you. They notice their own emotional reactions to you and consider what those might reveal about your relational experience. They share their perceptions and feelings when it serves the work, modeling a kind of authentic, boundaried intimacy that may be unfamiliar.
This mutual engagement—where both people are present, affected, and responsive—creates what's often called the "therapeutic action." Change happens not primarily through insight (though that matters) but through new relational experience. You begin to internalize a different kind of relationship, one where you can be seen fully and still be accepted, where ruptures can be repaired, where your needs and feelings matter.
What is RLT?
You might encounter the abbreviation RLT in discussions about therapy approaches. While it's not as standardized as acronyms like CBT or DBT, RLT typically refers to Relational Life Therapy, a specific model developed by Terry Real, LCSW, or more broadly to Relational Therapy as an umbrella term.
Relational Life Therapy, as conceived by Terry Real, focuses particularly on couples and family relationships, with an emphasis on moving from dysfunction to intimacy. It integrates systemic, psychodynamic, and feminist perspectives, addressing how patriarchal culture and family-of-origin patterns impact intimate relationships. This model tends to be more active and directive than traditional psychodynamic work, with the therapist taking a strong role in challenging relational patterns and teaching healthier ways of connecting.
More broadly, when therapists refer to "relational therapy" or RLT, they're often describing a therapeutic stance rather than a manualized treatment. This stance includes:
Mutuality and Authenticity: The therapist is real with you. They don't hide behind a professional mask or maintain rigid emotional distance. They share their genuine responses when appropriate, modeling authentic presence.
The Relationship as Primary: Rather than viewing the relationship as merely supportive while applying techniques, the relationship itself is understood as the primary vehicle for change. What matters most is what happens between you and your therapist—how you navigate connection, disconnection, vulnerability, and repair together.
Attention to Patterns: There's curiosity about patterns in how you relate—to your therapist, to others in your life, to yourself. These patterns are explored with compassion, understanding them as adaptive strategies developed in response to earlier experiences.
Co-creation and Intersubjectivity: Both you and your therapist influence what unfolds in sessions. The therapist doesn't position themselves as the expert who objectively analyzes you from the outside. Instead, they recognize they're part of the system, contributing to the dynamics that emerge.
Emphasis on Repair: Relational therapy expects that ruptures will happen—moments of disconnection, misunderstanding, or hurt. What matters is not avoiding these ruptures but repairing them. The process of repair itself is deeply healing, offering corrective experience for those whose early relationships lacked accountability or repair.
Developmental Understanding: Your current struggles are understood in the context of your developmental history. How you learned to be in relationship, what was modeled for you, what was safe or dangerous—all of this informs who you are now.
Whether you're working with someone practicing a specific RLT model or a therapist who takes a relationally-informed approach, the essence is similar: healing happens through the experience of being in a relationship that is safe, authentic, responsive, and reparative.
What are some Relational Therapy Techniques?
This is where relational therapy differs significantly from many other approaches. If you're looking for a list of techniques—worksheets, exercises, specific interventions you can expect in session—relational therapy may feel frustratingly vague. That's because it's not primarily technique-driven.
That said, there are particular ways relational therapists work that distinguish this approach:
Use of Self-Disclosure
Relational therapists may share their own feelings and reactions to what you share - they aren’t a blank slate. Relational therapists won’t burden you with their personal life, this work is still very boundaried, but they will be genuine about their experience of you and the relationship. If your therapist notices they feel protective toward you, or confused by something you've said, or moved by your courage, they might share that. This kind of transparency models emotional honesty and helps you understand your impact on others.
Here-and-Now Focus
While your history matters deeply, relational therapy pays close attention to what's happening right now, in the room. How are you with your therapist in this moment? What are you afraid might happen if you say what you're really thinking? What do you imagine your therapist feels about you? These present-moment inquiries illuminate patterns that might otherwise remain abstract.
Exploration of Transference and Countertransference
These are psychodynamic concepts, but in relational therapy they're understood more mutually. Transference refers to how you might unconsciously relate to your therapist as though they were significant figures from your past. Countertransference is the therapist's emotional response to you. Rather than viewing these as distortions to be interpreted, relational therapy explores them as meaningful information about your relational world and as opportunities for new experience.
Attention to Rupture and Repair
When something goes wrong in the therapeutic relationship—you feel misunderstood, your therapist says something that hurts, you feel disconnected—this isn't seen as failure. It's an opportunity. Relational therapists explicitly work with these ruptures, talking about what happened, acknowledging their part, and working toward repair. For many clients, this is the first time they've experienced someone taking responsibility and working through difficulty rather than avoiding it.
Process Over Content
While what you talk about matters, how you talk about it matters more. Your therapist notices how you tell your story, what's difficult to say, when you shift topics, when you intellectualize or minimize. They pay attention to their own reactions and the emotional atmosphere in the room. This process-level awareness reveals patterns that content alone might miss.
Collaborative Exploration
Rather than offering expert interpretations, relational therapists invite collaborative exploration. "I'm noticing I feel anxious when you talk about confronting your partner—I'm curious if that resonates with anything for you?" or "I wonder what it's like for you when I ask about that?" The work unfolds together, with both people contributing to understanding.
Normalizing and Contextualizing
Relational therapists help you understand your struggles not as personal failings but as adaptations to relational experiences. This isn't about blaming parents or removing responsibility, but about compassionately recognizing how you learned to be in the world and why certain patterns made sense.
The "technique” is the therapist's way of being with you—present, genuine, curious, responsive, willing to be affected and to work through difficulty. The healing comes from experiencing this kind of relationship over time, allowing new patterns to form.
How to Know if Relational Therapy is Right for You
Not every therapeutic approach fits every person or every situation. Understanding what relational therapy offers—and what it doesn't—can help you determine whether it aligns with what you're seeking.
Relational therapy may be particularly fitting if:
You struggle with patterns in relationships that you can't seem to change, despite understanding them intellectually. Perhaps you repeatedly attract unavailable partners, or find yourself in caretaking roles that leave you depleted, or struggle with intimacy even with people you love. Relational therapy works directly with these patterns as they show up in the therapeutic relationship.
You've tried more structured, skill-based therapies and found them helpful but insufficient. Maybe you learned coping strategies or challenged negative thoughts, but something deeper remains unresolved. Relational therapy addresses the relational roots of distress, not just surface symptoms.
You sense that your difficulties stem from early relationships or attachment wounds. If you grew up with inconsistent caregiving, emotional neglect, or relational trauma, relational therapy specifically addresses how these experiences shaped your development and continue to affect you.
You're drawn to depth and process rather than quick solutions. Relational therapy isn't usually brief. It unfolds over time, allowing patterns to emerge and new relational experiences to accumulate. If you're willing to engage in deeper, longer-term work, this approach offers that container.
You want a therapist who is real with you, not distant or overly clinical. If the idea of a therapist who shares their genuine responses and works collaboratively appeals to you, relational therapy offers this kind of authentic engagement.
You're interested in understanding yourself, not just changing behaviors. While behavioral change often occurs, it's not the primary goal. The aim is deeper self-understanding and relational healing, which then naturally influences how you think, feel, and behave.
Relational therapy may be less fitting if:
You're in crisis and need immediate stabilization or concrete skills. While relational therapists can certainly provide support during crisis, if you need urgent symptom management—for example, if you're in active addiction, acutely suicidal, or experiencing severe panic attacks—you might benefit from beginning with approaches that offer more structure and immediate tools, potentially integrating relational work later.
You prefer clear structure and specific homework. Some people find comfort in therapeutic approaches that provide worksheets, exercises, and between-session assignments. Relational therapy is less structured, which some experience as freeing and others find frustrating.
You're uncomfortable with emotional intimacy or boundaried therapist disclosure. If the idea of your therapist sharing their feelings or the therapy focusing on your relationship with them feels too exposing or inappropriate, you might prefer a more traditional, boundaried approach.
You're looking for brief, solution-focused therapy. If you have a specific, circumscribed issue and want targeted help rather than deeper exploration, short-term approaches like brief CBT or solution-focused therapy might be more efficient.
You prefer to keep your history separate from present work. Some people want therapy to focus entirely on current situations without much exploration of past relationships. Relational therapy inherently connects present patterns to developmental history, which isn't everyone's preference.
Questions to Consider:
As you think about whether relational therapy might serve you, consider these questions:
Do you notice repeating patterns in your relationships that you'd like to understand and change?
Does the idea of the therapeutic relationship being central to healing feel meaningful or concerning to you?
Are you willing to explore how your past relationships influence your present experience?
Do you value emotional depth and authenticity in relationships, including the therapeutic relationship?
Are you prepared for therapy that unfolds gradually rather than offering quick fixes?
How do you feel about a therapist who is real with you, rather than completely neutral all the time?
Your answers to these questions, combined with your gut sense, can guide you. It's also worth noting that therapy doesn't have to be either/or. Some therapists integrate relational approaches with other modalities, offering both the depth of relational work and the practical tools of other approaches.
Finding Relational Therapy in Denver
If relational therapy resonates with what you're seeking, finding a therapist trained in this approach is the next step. Not all therapists identify as "relational," but many integrate relational principles into their work, particularly those with psychodynamic training or strong grounding in attachment theory.
When searching for a therapist, look for language in their descriptions that suggests a relational orientation: references to the therapeutic relationship as central to healing, emphasis on patterns in relationships, attention to attachment and developmental history, integration of psychodynamic understanding. During a consultation call, you might ask directly about their approach and how they understand the role of the therapeutic relationship in their work.
What matters most is finding someone with whom you feel safe enough to be vulnerable, yet challenged enough to grow. The right therapist will help you explore your relational patterns with compassion, will be genuine in their presence with you, and will navigate the inevitable difficulties that arise with skill and care.
About Integration Psychotherapy LLC
Integration Psychotherapy LLC offers relationally-focused psychodynamic therapy for adults in Denver. Our practice is founded on the understanding that we become who we are in relationship, and that healing happens through the experience of a different kind of relational engagement—one characterized by attunement, authenticity, and the willingness to work through difficulty together.
Our Relational Approach
We practice psychodynamic therapy with a deeply relational orientation. This means we pay attention not only to what you share but to what unfolds between us—how you approach vulnerability, what patterns emerge in our work together, how we navigate moments of connection and disconnection. We believe these patterns offer profound insight into your relational world and, more importantly, that experiencing them differently in therapy creates the foundation for change.
We integrate multiple modalities—EMDR, Internal Family Systems, somatic awareness, and grounding techniques—but these interventions occur within a relational framework. The relationship is not simply the context for applying techniques; it's the primary therapeutic tool. How we are together matters as much as what we do together.
Our Understanding of Healing
We view your struggles through a developmental and relational lens. The ways you've learned to protect yourself, to manage relationships, to understand your worth—these adaptations made sense given your experiences. They may cause pain now, but they were once necessary. Our work honors this while helping you develop new possibilities that better serve your current life.
We believe healing requires more than insight. Understanding why you struggle is valuable, but it's not sufficient. What creates lasting change is the lived experience of a relationship that is safe enough to risk vulnerability, authentic enough to feel real, and resilient enough to survive rupture and repair. Over time, this new relational experience becomes internalized, changing not just how you think about yourself but how you feel in your body and in your connections with others.
Who We Work With
We work with adults navigating relational difficulties—patterns that keep showing up in intimate relationships, friendships, or work connections; struggles with trust, vulnerability, or intimacy; feelings of persistent loneliness even within relationships; difficulty setting boundaries or knowing what you need; conflicts between your desire for connection and your fear of it.
We also work with the aftermath of relational trauma—experiences of neglect, emotional abuse, or betrayal that have shaped your capacity to trust and connect. Whether your trauma stems from childhood relationships or adult experiences, we address how these wounds continue to affect your sense of self and your relationships.
Our Therapeutic Presence
We show up as real people in this work. We're warm, grounded, and genuine in our presence with you. We don't hide behind professional jargon or maintain clinical distance. We care about this work and about the people we're privileged to accompany in their healing.
This doesn't mean we're your friend or that boundaries don't matter—they do. But within appropriate professional boundaries, we're authentically present. We share our responses when it serves the work. We take responsibility when we miss something or when we contribute to a rupture. We work collaboratively with you, respecting that you are the expert on your own life.
Our Commitment
We are committed to ongoing consultation and professional development to ensure we provide skilled, ethical, relationally attuned care. We recognize that working with relational wounds requires us to be continually aware of our own patterns and how we show up in relationship. We take this responsibility seriously.
We also recognize the courage it takes to reach out for help with relational struggles. Many people spend years feeling isolated in their pain before seeking support, sometimes wondering if something is fundamentally wrong with them. If you're considering therapy, we want you to know: your struggles make sense given what you've experienced, healing is possible, and you don't have to do this alone.
Getting Started
Integration Psychotherapy LLC serves adults in the Denver area. We offer a free initial consultation to discuss your needs, answer questions about our approach, and help you determine whether our practice is the right fit for your healing journey.
In that consultation, you'll get a sense of what it's like to work with us. We'll listen to what brings you to therapy, share how we might approach working together, and answer any questions you have. There's no pressure or expectation—just an opportunity to see whether this feels like a good fit.
The therapeutic relationship begins from that first contact. How you feel in that initial conversation—whether you feel heard, whether our approach resonates, whether you sense you could be real with us—matters. Trust that sense.
In the spirit of transparency and authenticity, this blog post was constructed with AI assistance for informational, educational, and marketing purposes. Erin does not use AI in her sessions or in her note-taking of sessions.
