Power dynamics
We are living in a world where power is unevenly distributed and continuously negotiated – between the wealthy and the impoverished, the privileged and the disadvantaged, the majority and minority, and between the Global North and Global South. These are not abstract distinctions. They are lived realities, shaping access, opportunity, safety and voice. On the global stage, authoritarian leaders of powerful states exert influence in ways that ripple far beyond their borders, shaping political, economic and environmental conditions for others.
With our training in psychological processes, we also recognise how these external dynamics are mirrored internally and interpersonally. We understand how the bullied can become the bully, how the victim may, under certain conditions, become the perpetrator, and how persecution can be transformed into persecutory dynamics in turn. These patterns are not only visible in the wider world but are also reflected in the consulting room, and in the more private landscapes of our own inner lives.
Given the nature of therapeutic work – inviting clients to disclose their most vulnerable, intimate and often painful experiences, while offering comparatively little in return – therapists inevitably occupy a position of power. Whether consciously acknowledged or not, this asymmetry requires ongoing reflection. It calls for supervision, personal therapy and sustained self-examination in relation to how that power is held, enacted and sometimes defended against.
There is also a risk of inflation when working with clients who idealise us, positioning the therapist as someone who is ‘sorted’ or in possession of answers. Many practitioners are drawn to this profession because of their own histories of wounding and unmet needs. In such contexts, it can become unconsciously tempting to use clients as a source of affirmation or narcissistic reassurance. At the other end of the spectrum, there is the risk of collapse into self-doubt or defensiveness when clients relate to us as ineffective, frustrating, or ‘bad’ objects. Without awareness of our own vulnerabilities, we risk enacting, rather than understanding, these dynamics within the therapeutic relationship.
Because power is always shaped by intersecting aspects of identity – some visible, others less so – it is essential that therapists remain mindful of how they are positioned in relation to their clients. Gender, age, race, ethnicity, sexuality, class, physical ability and neurotype all contribute to how we are perceived and how we, in turn, perceive others. These intersections are not incidental; they are active within the relational field of therapy.
One area where these dynamics can become particularly complex is within the institutions responsible for training therapists. A recent article in The Guardian¹ reported accounts from graduates describing experiences of bullying and toxic cultures within some training organisations. While it is important to recognise that such perceptions may, at times, reflect transference or projections rooted in earlier relational experiences, it would be overly simplistic to assume this is always the case. Where concerns are raised, they warrant careful, non-defensive engagement. Training bodies carry a responsibility not only to educate but to reflect on their own use of authority and power. Without this openness, there is a risk of repeating the very patterns of relational harm that many of us, in different ways, have experienced ourselves.
Within clinical practice itself, we also encounter complex relational configurations. At times, clients may present in ways that seem resistant to engagement or change. As one supervisor once suggested to me, some clients may not come to therapy primarily in search of improvement, but to test whether it will fail. In such situations, even accurate reflections or empathic attunements may be rejected. Attempts at understanding can be met with frustration, dismissal or hostility.
In these encounters, the therapist may become positioned as a stand-in for earlier relational figures – often caregivers who were experienced as inconsistent, unavailable, or unsafe. What unfolds in the therapeutic space can then become a replaying of earlier attachment injuries, including anger, disappointment, shame, envy and longing. The consulting room becomes a place where these previously unmanageable experiences can, at least in principle, be brought into awareness.
This is demanding work. It requires the therapist to remain present under pressure, to tolerate projection and negative transference, and to resist defensive withdrawal. Yet even when this is managed well, it does not guarantee repair. Some clients may end therapy abruptly, unable to bear the dependency it evokes, or unwilling to risk further disappointment. The original wound remains, even if the therapeutic encounter has briefly illuminated it.
It is important to recognise too that the systems designed to regulate and uphold professional standards can themselves become sites of significant emotional and relational strain. While complaints procedures are essential for safeguarding clients and maintaining ethical practice, they must also acknowledge the complexity of therapeutic work and the unconscious dynamics that can emerge within it. Therapists, by the very nature of their role, are exposed to intense relational projections that can make them vulnerable to criticism, misunderstanding, and attack.
Against this backdrop, developments that offer support to practitioners navigating professional conduct processes are to be welcomed. A more balanced approach – one that holds both accountability and care – may help ensure that ethical standards are upheld without inadvertently replicating adversarial dynamics that leave practitioners unsupported at moments of acute professional vulnerability.
Reference
1. Bradley J. ‘Real nastiness’: therapist training courses in UK can be ‘toxic’ and need regulating, say students. https://tinyurl.com/janamazw (accessed 29 July 2025).
This is an edited extract from an editorial first published in Private Practice, September 2025, published by BACP©