As a psychotherapist, for me the therapeutic presence is a unique way of being with my clients that promotes what happens in a therapeutic session. It involves active engagement in the encounter with my clients, where I am simultaneously aware of various levels of experience: the body, the emotional, the cognitive, and the relational.

From the perspective of bodily sensations, presence is a subjective state with a multitude of focal points: awareness of being centered in oneself, being absorbed in the present moment, and an expanded sense of spatial perception. These qualities have been associated with the concept of Flow in scientific literature, where the subjective perception during complex tasks requiring high concentration is experienced as a natural state that doesn’t require special effort (Csikszentmihalyi, 2013).

However, therapeutic presence also requires a relational component and the therapist’s intention invariably directed towards the client’s well-being.

Presence in the Therapeutic Context

In every therapeutic process, the therapeutic relationship is paramount for achieving therapeutic objectives, regardless of the therapeutic modality. Even in approaches more focused on technical interventions, the therapist’s role is crucial for progress to occur. A necessary precursor to creating a climate of safety with the client, facilitating the development of a strong therapeutic relationship and effective therapy is the therapeutic presence (Geller, 2017).

Therapeutic presence requires the therapist’s ability to tune with their body into the client’s experience while remaining aware that they are accompanying them, moment by moment. It involves a kind of intimacy with the client that is highly absorbing yet anchored in one’s own experience. Thus, therapeutic presence is more than just a personal subjective state, it fosters the creation of a unique relational process through which a delicate intimacy emerges: to see and to be seen.

Studies have described how therapeutic presence can impact us at a microscopic level, potentially altering our epigenetics, improving our health, and well-being (Parker et al., 2015). Additionally, research has shown that the experience of someone who is empathetically connected can enhance immune system functioning (Rakel et al., 2009). There is a demonstrated correlation between the quality of therapeutic presence and better therapeutic outcomes, making it the most predictive factor for therapeutic change, irrespective of the therapeutic approach—whether it’s based on technical interventions like cognitive-behavioral therapy or relationship-based approaches like person-centered therapy or emotion-focused therapy (Geller et al., 2010).

Therapeutic Presence and Humanistic Psychotherapy

Intrinsic to the humanistic approach is considering clients not as clinical cases but as unique human beings with different expressions, personalities, challenges, and equally unique needs. Compared to other therapeutic approaches, interventions in the humanistic approach are not so focused on the application of specific protocols or techniques but on fostering therapeutic change through the therapist-client relationship.

The creation of this therapeutic alliance directly depends on the therapist’s ability to accompany the client, relate to their subjective world, create a safe context where the client can move towards the healthier spectrum of their personality, and develop their innate potential. The therapeutic presence is the foundation upon which these processes rest.

Presence in our lives and in a session

Our contemporary society has embraced mode of living based on a constant occupation, the goal of ceaselessly collecting achievements, the unending pursue of ever more efficient processes, the compression of time, and the expansion of activity.

Sadly, this perspective can also infiltrate the therapeutic practice through business, or prescriptive approaches emphasizing the importance of methodological efficiency and technical mastery. Nonetheless, we as therapists are responsible to foster the relational qualities necessary for the therapeutic presence. It is thus essential for us therapist to slow down personal experience and to delve deeper in the contact with oneself and others.

A key aspect of practicing therapeutic presence involves a shift in information processing. Cognitive skills such as analysis or logical reasoning are not given the central stage in a session, but they coexist with sensory and intuitive knowledge, complementing each other. This requires the therapist to develop the ability to be in touch with and understand their subjective world while simultaneously being accessible for the therapeutic relationship.

The practice of therapeutic presence demands dual awareness from the therapist: the ability to continuously alternate between objective awareness (theoretical knowledge and accumulated experience) and subjective awareness (what they feel in the present moment). Therapeutic presence is not based on what we do but on how we do it, signaling a paradigm shift from independence to interdependence, from doing to being (Geller, 2017).

Conclusion

In my practice as a psychotherapist, the conscious use of my therapeutic presence plays a key role in the therapeutic work.

This foundational state is felt without words and serves as the basis for any intervention. I strongly believe that being in the presence of another human being who is available and grounded is inherently healing.

It creates the perfect context for any psychotherapeutic work. Whether in the experience of dire or happy moments, being in the presence of another attuned person makes us feel attended to and connected, helping us to more authentically endure or enjoy our life experiences.

Csikszentmihalyi, M. (2013). Flow: The psychology of happiness. Random House.

Geller, S. M. (2017). A practical guide to cultivating therapeutic presence. American Psychological Association.

Geller, S. M., Greenberg, L. S., & Watson, J. C. (2010). Therapist and client perceptions of therapeutic presence: The development of a measure. Psychotherapy Research, 20, 599–610.

Remon, I. M. (2023). La Presencia Terapéutica. Master thesis. Instituto Galene, Madrid, Spain.

Parker, S. C., Nelson, B. W., Epel, E. S., & Siegel, D. J. (2015). The science of presence. Handbook of mindfulness: Theory, research, and practice, 225.

Rakel, D. P., Hoeft, T. J., Barrett, B. P., Chewning, B. A., Craig, B. M., & Niu, M. (2009). Practitioner empathy and the duration of the common cold. Family Medicine, 41, 494–501.