Choose therapeutic relationship before modality
“The therapist must strive to create a new therapy for each patient.” — Irvin Yalom
A big part of my work at Kapwa Psychology centres on the therapeutic relationship and on supporting clients in returning to a sense of connection and safety in the world. That's not always the question people arrive with, though. Social media and information online can be heavily focused on modality. Should you try EMDR? Somatic therapy? CBT? DBT? Something else? It's a reasonable place to start. But the relationship tends to matter as much as, if not more than, the method used.
The therapeutic alliance
Psychology has a name for this: the therapeutic alliance. It's usually described as having three parts:
Goals - a shared agreement on what we're working toward
Tasks - mutual agreement on how we'll get there
Alliance - the bond between client and therapist
This is gradual and builds over time. Does the work feel collaborative? Can you say when something isn't landing? Does your therapist gently challenge you on patterns that move you away from your goals? These are the things that build a sense of connection and safety in the therapeutic space.
On the quality of presence itself
I think of this as something close to what the psychotherapist Ron Kurtz called loving presence.
He described it as a quality the therapist brings into the room before any technique is used at all. It is a genuine felt experience that's unhurried, accepting, without an agenda to fix or change anything in that moment. He believed people carry their own internal wisdom about how to heal, and that the work isn't about driving that process but about creating conditions safe enough for it to unfold in its own time.
On the relationship as the therapy itself
Irvin Yalom said something similar from a different angle. He described the relationship itself as a therapeutic intervention. What happens between two people in the room, right now, tends to matter more than any technique layered on top of it. This resonates with the way I like to work - that a felt sense of safety and connection with another person is healing in itself.
What this looks like in body image and eating disorder work
For people navigating disordered eating and body image concerns, this often looks a little different in practice. This work usually involves a body that's been treated as a problem to be managed, sometimes for years, sometimes by well-meaning professionals and systems. A collaborative relationship is often someone's first experience of being supported alongside, rather than managed. That means the pace and direction of therapy is something we build together, and that your existing wisdom about your own body and history becomes part of the therapeutic experience, not something to override.
You can read more about my approach here.
Why connection shapes how I think about this
In my practice, I'm inspired by kapwa, a concept from Filipino psychology, and by other non-Western frameworks for understanding the self, in which we are always deeply connected to the world around us and to each other. For those who resonate with this, I bring it into how I practice. It shapes the sense that healing isn't worked out alone inside one person, but through relationship, and through a return to feeling connected and safe.
Practically, this looks like being transparent about my thinking as we go, checking in on how sessions are landing for you, and treating any modality as something we choose together based on what you're bringing, rather than something I apply to you. It also means we thoughtfully consider how your social and cultural environment might need to shift to support your overall health and wellbeing.
So does modality matter at all?
Of course. Extended EMDR sessions exist because more time in a single session allows fuller processing of stuck material rather than stopping partway through. Somatic approaches matter because trauma often lives in the body in ways that talking alone doesn't always reach. Evidence-based approaches in eating disorder care are important for positive outcomes.
But they only help when practised within a relationship that feels safe enough to hold them. A well-delivered technique inside a relationship that doesn't feel safe enough tends to land badly. A less developed technique within a relationship that does feel safe enough often still moves something.
A note on safety
I'm mindful that safety is a loaded word, and it isn't experienced the same way by everyone. For people who've had reason to distrust systems, whether that's the healthcare system, institutions, or professionals more broadly, safety in a therapy room has to be earned. This will look different depending on someone's history, culture, and lived experience of being believed, dismissed, or managed by people in positions of authority. A good therapeutic relationship has to be cultivated over time, and you're the one who gets to decide when and whether it feels that way.
If you're deciding whether to reach out
You don't need to arrive having already worked out whether you need EMDR, somatic therapy, or something else. That's something we can figure out together, informed by what you're bringing and what's actually helped or not helped before. The more useful question to sit with is simpler - does it feel like it could be safe enough to be honest with this person?
If you're not sure, that's completely okay. A short initial conversation, before any commitment to ongoing sessions, often answers that question faster than research or reading ever will. If any of this resonates, you’re very welcome to reach out and request an introductory call.
I'm Maejoy Obach, a Clinical Psychologist and Accredited EMDR Practitioner. My work is grounded in kapwa - the belief that healing happens in connection, not in isolation. I offer trauma informed, relational therapy in Coffs Harbour and via telehealth across Australia, including EMDR Intensives for people wanting more focused, concentrated work. If anything here resonates, I'd love to hear from you.
