In the Here-and-Now or Why Relationships Matter
20 Dec – written by Katrin Kemmerzehl – Blog
Most people don’t come to counselling because something is “wrong” with them in isolation.They often come because something has shifted — a relationship ended, a role changed, a loss wasn’t fully processed, or life no longer feels the way it used to.
Often, when people talk about feeling low, anxious, stuck or disconnected, it quickly becomes clear that these feelings are closely tied to what’s been happening between them and others.
Interpersonal Therapy (often called Interpersonal Psychotherapy, or IPT) starts from this very human place. It’s based on the idea that our emotional wellbeing is deeply shaped by our relationships, our social world, and the transitions we move through across life (Weissman, Markowitz & Klerman, 2017).
Rather than asking, “What’s wrong with you?”, IPT gently asks: “What’s been happening in your life and relationships, and how has that affected you?”
Relationships, Life Events and Emotional Wellbeing
Interpersonal Therapy is a form of talking therapy that focuses on the connection between your relationships, life events, and emotional wellbeing.
It was originally developed as a treatment for depression, at a time when depression was often seen as something located entirely within the individual, such as a flaw, a chemical imbalance, or a personal weakness. IPT challenged this idea by recognising something many of us already know intuitively: that how we feel is strongly influenced by what’s happening around us.
Loss, conflict, isolation, and major life changes can all have a powerful impact on our mental health (Weissman et al., 2017).
The effects of interpersonal distress
Feeling low, anxious, or overwhelmed is often an understandable reaction to difficult circumstances, especially when support feels limited or relationships feel strained.
IPT views emotional distress not as a personal failure but as a meaningful response to interpersonal stress. One of the most compassionate aspects of IPT is how it normalises distress. Rather than pathologising feelings, IPT understands symptoms as signals.
A Relational Way of Understanding Emotional Difficulties
Depression, anxiety, or emotional numbness may be telling us that something in our relational world needs attention (Cuijpers et al., 2016).
Emotional difficulties might emerge after:
- the end of an important relationship
- becoming a parent or carer
- redundancy or retirement
- ongoing conflict with a partner, friend, family member, or colleague
- feeling lonely, isolated, disconnected, misunderstood or unsupported
Therapists doesn’t assume that these experiences affect everyone in the same way. Instead, they might be curious about your unique relationships, your expectations, your support network, and how changes in these areas may have impacted you.
The Importance of the Here-and-Now
Rather than analysing childhood in depth or spending a lot of time examining thought patterns, IPT focuses on the here and now of your life. In practice it often feels collaborative, warm, and flexible, shaped around what matters most to you right now.
The work usually centres around the areas that feel most relevant to your current difficulties (International Society of Interpersonal Psychotherapy).
Grieving losses
Often this includes experiences of grief and loss. This doesn’t only mean bereavement, but also losses that are less openly acknowledged — such as loss of identity, loss of health, infertility, or the ending of a friendship or relationship that was never fully mourned.
Sometimes grief doesn’t resolve on its own and continues to affect how we relate to others and ourselves (Bylund-Grenklo et al., 2016).
Life changes and Transitions
Another common focus is role transitions. Life changes, even positive or expected ones, can be surprisingly destabilising.
Becoming a parent, separating from a partner, moving country, changing career, or adjusting to illness can all bring a sense of disorientation.
A therapist can help you make sense of what has been lost, what is emerging, and how relationships may need to shift as a result (Weissman et al., 2017).
Relationship difficulties
Some people come to counselling because of loneliness or difficulties with closeness. They may feel disconnected, struggle to maintain relationships, or find it hard to express needs and emotions.
In addition, ongoing tension, unspoken resentment, or repeated misunderstandings can quietly drain emotional energy.
Therapy can help gently explores these patterns and supports the development of more satisfying connections. A therapist can support you clarify expectations, improve communication, and explore whether relationships can be repaired, renegotiated, or approached differently (Knobloch-Fedders & Wilson, 2020).
What Is It Like to Be in Interpersonal Therapy?
Sessions are usually experienced as active, supportive, and collaborative.You and your therapist work together to understand how your relationships and life events connect to how you’re feeling.
This might involve noticing patterns, exploring emotional responses, and reflecting on how you communicate with others, and how they respond to you.
In contrast to a distant observer, the therapist is engaged and involved, offering reflections, helping you make links, and supporting you to try out new ways of relating. The focus is on understanding and curiosity.
Connection, belonging, meaning, and the fear of isolation
Irvin Yalom is an existential psychiatrist, therapist and author and had a strong influence on relational ways of working in therapy.
He believed that psychological suffering is, at its heart, relational. He suggested that many emotional difficulties arise from struggles around connection, belonging, meaning, and the fear of isolation (Yalom, 2002).
One of his most important contributions is the emphasis on the “here-and-now” relationship between therapist and client.
“The therapist must attend not only to what the patient talks about, but to what happens between therapist and patient.” – Irvin Yalom (Yalom & Leszcz, 2020).
Yalom noticed that people often bring their familiar relationship patterns into therapy without realising it. How someone relates to their therapist may echo how they relate to others in their life, such as holding back emotions, fearing criticism, seeking reassurance, or expecting rejection.
Many therapists integrate Yalom’s insight by paying attention to what is happening within the therapeutic relationship itself.
Symptoms as Interpersonal Signals
Yalom also suggested that symptoms often serve a purpose in relationships, even if unconsciously. Depression, for example, may express helplessness or signal a need for change and care. Anxiety may protect against rejection or loss. Anger may create distance or regain a sense of control (Yalom, 2002).
From this perspective, symptoms can also be understood as attempts to cope within a relational and social world.This idea fits closely with IPT’s understanding that emotional difficulties are deeply connected to how we relate to others and to ourselves.
Healing Through Relationship
Much of Yalom’s thinking developed through his work with group therapy, where interpersonal patterns become visible very quickly. He described how people learn about themselves not just through insight, but through being experienced by others (Yalom & Leszcz, 2020).
Change often happens through moments of emotional connection, when someone feels seen, understood, or responded to differently than they expect.
Positive relationships themselves, including a positive therapist-client relationship, can be healing.
Does Interpersonal Therapy Work?
IPT is one of the most researched therapies for depression and has strong evidence for helping with anxiety linked to relationship stress, eating disorders, and trauma-related difficulties in adapted forms (Cuijpers et al., 2016).
Is Interpersonal Therapy Right for You?
Interpersonal Therapy may be a good fit if your difficulties are closely linked to relationships or life changes, or if you find that connection, loss, or conflict plays a central role in how you’re feeling.
It can also be a helpful approach if you prefer therapy that feels relational and grounded in real-life experiences, rather than focused on diagnoses or techniques alone.
Interpersonal Therapy reminds us of something deeply human: we don’t heal in isolation. We change through understanding, connection, and being met with compassion — in the therapeutic space, and then gradually in the wider world. As Yalom put it: “It is the relationship that heals.” (Yalom, 2002)
If you’d like to explore this more in counselling, I’m warmly inviting you to reach out.
References
- Cuijpers, P., Donker, T., Weissman, M. M., Ravitz, P., & Cristea, I. A. (2016). Interpersonal psychotherapy for mental health problems: A comprehensive meta-analysis. American Journal of Psychiatry, 173(7), 680–687.
- Bylund-Grenklo, T., et al. (2016). Unresolved grief and its consequences. Supportive Care in Cancer, 24(7), 3095–3103.
- International Society of Interpersonal Psychotherapy. (n.d.). Overview of IPT.
- Knobloch-Fedders, L. M., & Wilson, S. J. (2020). Interpersonal behaviour in couple therapy. Psychotherapy Research, 30(2), 183–194.
- Van Hees, M. L., et al. (2013). The effectiveness of interpersonal psychotherapy. BMC Psychiatry, 13, 22.
- Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2017). The Guide to Interpersonal Psychotherapy. Oxford University Press.
- Yalom, I. D. (2002). The Gift of Therapy. HarperCollins.
- Yalom, I. D., & Leszcz, M. (2020). The Theory and Practice of Group Psychotherapy. Basic Books.
Katrin Kemmerzehl
I am a qualified psychotherapeutic counsellor in Newcastle upon Tyne. Please get in touch if you’re interested in arranging a consultation.