Within the field of psychoanalytic psychotherapy it is among psychoanalysts and clinicians widely believed that psychoanalytic psychotherapy mainly works in virtue of the interaction tied to the relationship that exists between client and therapist in psychoanalytic psychotherapy. The question about what more precisely can be understood by change in the therapeutic relationship has not evidently been specified, and at the same time it is still an unclarified and controversial subject how the process in the therapeutic relationship causes effective therapeutic change. Thus the purpose of this thesis is to examine what more specifically about this interaction in the therapeutic relationship can lead to therapeutic changes in the client in psychoanalytic psychotherapy. Furthermore, the purpose of this thesis is to clarify the importance of the therapist’s own emotional processes and the contribution of these in relation to the client in a process of change in the therapeutic relationship.

To achieve a differentiated understanding of what causes changes in the therapeutic relationship, this thesis was examined in the light of a psychoanalytic theoretical perspective that in spite of its many comprehensive and enriching areas has been delimited to the theories, which for the present examination were evaluated to be most contributive. The different psychoanalytic theories were examined with the aim of clarifying what each of them associate with change in the therapeutic relationship. The examination discovered that each theory involves the therapeutic relationship to a certain extent, and the mechanisms in this as agents of therapeutic change. However, there happens to be a difference between the psychoanalytic theories in proportion to what they associate with the intended goals of change in psychoanalytic psychotherapy as well as the importance of the role of the therapist in the process of change. These differences led to a discussion, where each theory was examined in relation to the psychoanalytic goals of change as well as transference and countertransference as mechanisms of change in the therapeutic process. In the light of the discussions, it was determined that change in the therapeutic relationship is best explained through psychoanalytic theoretical perspectives such as the object-relations theory, where the therapist’s handling of her own emotional processes is a crucial part of the therapeutic relationship, and can thus lead to inner changes in the client. Therefore, the discussion was at last differentiated by parts of the object-relations theory as well as other contributing psychoanalytic theoretical perspectives in relation to the therapist’s own emotional processes and the importance of these in relation to the client’s process of change.

The thesis found that the therapeutic relationship is effective in virtue of the emotional interaction that exists between client and therapist in psychoanalytic psychotherapy. Hence the process of change in the therapeutic relationship can be perceived as depending upon the therapist’s handling of her own emotional processes, which can generate the client’s own ability to handle painful experiences and feelings. Thus the emotional interaction between client and therapist in the therapeutic relationship is the cause that brings along inner structural and deep changes in the client’s personality. Although the therapeutic relationship is frequently interpreted as a healing bond, this thesis argues that the therapeutic relationship is not an aspect of healing itself, but rather it is the emotional and often the unconscious emotional interaction tied to the relationship between client and therapist that causes changes in the client. The emotional interaction between client and therapist can therefore be perceived as a healing conversation, and thus as the agent of therapeutic change.