Mahan Doğrusöz: What impressed me most about Developmentally Based, Relationally Focused Integrative Psychotherapy was its emphasis on the therapeutic relationship, its focus on the therapist’s presence rather than interpretation, its sensitivity to attunement with the client, and its positioning of the therapist not as a “knowing authority” but as a curious human being who bears witness to the client’s suffering. I was also deeply struck by the way it views therapy not merely through the lens of mentalization or insight, but as a holistic process that addresses body, emotion, cognition, and behavior together. In your view, what most fundamentally distinguishes this approach from other dominant schools of psychotherapy?
Soley Sezgin Akten: The most fundamental distinction of Developmentally Based, Relationally Focused Integrative Psychotherapy—particularly Richard Erskine’s relational model—is the answer it gives to the question: Where does healing occur?
Classical psychoanalysis positions the therapist as a “blank slate” and largely defines healing in terms of resolving transference and gaining insight. In the integrative model, however, insight alone is not enough. The therapist is not a distant interpreter but a presence who enters the room with their full humanity, emotions, and authentic self. Healing begins not primarily through analyzing the past, but through having the pain of that past seen, acknowledged, and witnessed for the first time within a safe relationship.
Within this perspective, symptoms are not viewed as disorders to be eliminated but as creative survival strategies developed to endure existential crises in the past. The therapist is not a knowing authority but a curious companion who explores the client’s inner world alongside them.
Many therapeutic schools approach human beings in a fragmented way: some focus primarily on cognition and behavior, others on emotion, and still others on the body. The integrative approach, by contrast, simultaneously embraces the cognitive, physiological, emotional, and behavioral dimensions of human experience. This integration facilitates the reunification of fragmented aspects of the self and developmental fixations through the therapeutic relationship.
Mahan Doğrusöz: Developmentally Based, Relationally Focused Integrative Psychotherapy draws upon powerful traditions such as Carl Rogers’ humanistic approach, Fritz and Laura Perls’ Gestalt therapy, and Transactional Analysis. What do you believe it inherited most fundamentally from these traditions? And in what ways has it moved beyond them to establish its own distinctive theoretical and clinical framework?
Soley Sezgin Akten: Developmentally Based, Relationally Focused Integrative Psychotherapy is a synthesis rooted in powerful traditions, yet one that has grown into an entirely new tree from those roots.
It fully inherits Carl Rogers’ principles of unconditional positive regard, empathy, and congruence. Richard Erskine frequently acknowledges Rogers with great respect in his writings. Yet he takes this legacy a step further through the concept of attunement. While Rogers’ empathy is primarily verbal and reflective, attunement involves accompanying the client’s emotional rhythm, developmental needs, and lived experience in a holistic way.
The Gestalt principles of the here and now, contact, and tracking unfinished experiences as they manifest in emotions and bodily sensations have also been incorporated. Most integrative therapists work in the room much like a Gestalt therapist. Chair work, giving voice to inner dialogues, and facilitating conversations between conflicting internal parts are all interventions that deepen awareness and strengthen contact with oneself. However, within Integrative Psychotherapy, confrontation is largely replaced by respectful curiosity and phenomenological inquiry.
Richard Erskine, the founder of Developmentally Based, Relationally Focused Integrative Psychotherapy, spent many years working within Transactional Analysis. Yet in developing Integrative Psychotherapy, he significantly expanded TA’s concept of the life script. He enriched what can sometimes become an overly cognitive and schematic framework with a deeply relational and developmental emotional dimension.
Erskine reminds us that ego states must be understood and worked with on behavioral, social, historical, and phenomenological levels. He acknowledges that the functional analysis of ego states is useful for psychoeducation and more behaviorally oriented therapies, but argues that reducing them solely to this level risks losing the psychoanalytic elegance originally envisioned by Eric Berne.
Integrative Psychotherapy does not define itself as an eclectic approach. Rather, it creates a unique clinical framework by integrating diverse theories around the axes of relational needs and developmental attunement. Its principles of inquiry, attunement, and involvement provide therapists with a powerful therapeutic roadmap.
Mahan Doğrusöz: What were the primary factors that drew you, both as a person and as a psychotherapist, to Developmentally Based, Relationally Focused Integrative Psychotherapy?
Soley Sezgin Akten: The most important aspect that drew me to this approach is that it allows the therapist to be present in the therapy room with their own humanity. To be, first and foremost, a human being—and only then a therapist.
Unlike many schools of psychotherapy, this approach gives me permission to bring my own vulnerability, heart, and authentic presence into the therapeutic encounter.
One of the things that has affected me most deeply is the profound respect and kindness evident in Erskine’s writings and session recordings. To approach even a client’s most defensive or angry behavior with the question, “What early wound is this behavior trying to protect?” is not merely a technique—it is a way of being in the world.
I also deeply value the fact that this approach does not view human beings as broken or deficient, but as individuals who naturally possess an innate drive toward healing and integration. It reminds us that therapy is not fundamentally about doing something to clients, but about being with them. This understanding makes my profession both sustainable and meaningful.
Mahan Doğrusöz: It is often said that Turkey has one of the fastest-growing communities of Developmentally Based, Relationally Focused Integrative Psychotherapy practitioners in the world. What cultural and professional dynamics do you think lie behind this development?
Soley Sezgin Akten: There are both cultural and professional reasons why this approach has found such a strong resonance in Turkey.
While many Western societies are structured around individualism and autonomy, Turkish culture is fundamentally relational, community-oriented, and open to emotional closeness. We experience both our joys and our sorrows within relationships. For this reason, approaches that primarily analyze the client can sometimes feel distant to many people.
The concepts of presence, companionship, and attunement offered by Developmentally Based, Relationally Focused Integrative Psychotherapy are, in many ways, scientific and clinical counterparts to cultural notions such as being deeply connected, forming a bond of the heart, and understanding another’s inner state.
At the same time, Turkey’s psychotherapy community is remarkably dynamic and eager to learn. Many therapists discover through experience that purely technical interventions may be insufficient when working with deep childhood trauma or complex personality structures. The flexibility and depth offered by the integrative approach provide a richer and more professionally satisfying framework.
Mahan Doğrusöz: Erskine describes the concept of the Relational Home as a safe psychological space where clients can breathe deeply and reveal themselves without fear of humiliation. What therapeutic principles does Developmentally Based, Relationally Focused Integrative Psychotherapyemphasize in order to create such an atmosphere?
Soley Sezgin Akten: The safe psychological space that Richard Erskine calls a Relational Home does not emerge by chance. It is carefully built upon a set of fundamental therapeutic principles.
The therapist does not assume they already know what the client feels. Instead, they approach the client’s subjective experience with profound respect through phenomenological questions such as, “What does this mean for you?” or “What was happening in your inner world at that moment?” The moment clients realize they will not be judged and will be accepted as they are, they begin to settle into that relational home.
Attunement is equally important. It is the warmth of the home itself. Attunement involves much more than words. It means attuning to the client’s tone of voice, body language, breathing patterns, and even their developmental age in that moment. The therapist creates in the room the very experiences the client may have longed for but never received from significant others in childhood—perhaps a compassionate tone of voice, genuine eye contact, or an emotionally responsive presence.
Participation, acceptance, and normalization are also essential. The client’s most shame-laden and feared defenses—lying, avoidance, emotional withdrawal, or angry outbursts—are met with responses such as: “At that age, under those circumstances, you were completely justified in doing what you needed to survive. You had no other choice.” This is the antidote to shame.
Consistency and reliability are equally central to the relational home. This means that the therapist remains emotionally present and stable. When clients become angry, cry, or fall silent, they learn that the therapist will not abandon them, collapse, or punish them. It is this reliability that makes the relational home secure and enduring.
Mahan Doğrusöz: I am particularly moved by the fact that Erskine sometimes asks his clients, “Is there anything you would like me to do differently today?” In cultures where hierarchical relationships are strong, clients may hesitate to criticize their therapist or express disappointment. Why do you think it is so important that therapists remain open to criticism?
Soley Sezgin Akten: Questions such as “Is there anything you would like me to do differently today?” or “Was there a moment when I failed to hear or understand you?” represent some of the highest points of therapeutic work.
In a culture where hierarchy, obedience to elders, and reverence for authority are strongly valued, these questions become even more significant. Many clients carry childhood wounds rooted in being silenced, punished for criticism, or disappointed by authority figures such as parents or teachers. If the therapist remains an unquestionable authority, the client’s old submissive or passive-aggressive relational patterns are simply recreated within therapy.
When therapists explicitly invite criticism and respond to it with maturity, curiosity, and openness rather than defensiveness, something extraordinary happens. The client discovers: “I can feel angry with an authority figure. I can criticize them. And the relationship does not collapse. I am not abandoned.”
For many clients, this is an entirely new relational experience.
When therapists remove the mask of perfection and are able to say, “You’re right. I missed that important statement you made last week. I imagine that may have left you feeling alone,” the relationship shifts from a hierarchical structure into a collaborative creation between two adults.
Mahan Doğrusöz: Erskine argues that therapists cannot conduct truly deep therapy through technical knowledge alone; they must also be in touch with their own childhood wounds. What would you like to say to younger colleagues about the therapist’s personal journey?
Soley Sezgin Akten: Technical knowledge is only a therapist’s outer armor. In the therapy room, two unconscious minds are communicating.
If therapists have not confronted their own childhood wounds, life scripts, fears of worthlessness, or fears of abandonment, then when a client touches those same areas of pain, therapists may unconsciously become defensive. In an effort to soothe their own anxiety, they may rush to reassure the client or prematurely change the subject.
A therapist who has not descended into their own darkness cannot accompany another person through theirs.
Developmentally Based, Relationally Focused Integrative Psychotherapy does not teach us to become perfect therapists. It teaches us to become therapists who are aware of their wounds and have worked to transform them. The greatest healing environment we can offer clients is not that we have never suffered, but that we know suffering from within and have learned how to remain present with it.
Young therapists should invest at least as much in their own therapy as they do in books. Just as importantly as receiving supervision, they must be willing to sit in the client’s chair and explore the fragmented aspects of their own selfhood.
Technical knowledge may make you feel safe, but what heals clients is not your knowledge itself—it is the humanity with which you use it.
Finally, one of the most valuable lessons I have learned from Integrative Psychotherapy is that we should strive to be with our clients rather than trying to make something happen. Instead of becoming impatient or overly interventionist, we must trust the natural unfolding of the process and the unique experience created by two human beings together.
Therapy is both an art and a science. The art lies in our ability to establish a genuine relationship and to be fully present. The science lies in our ability to evaluate what is and is not effective.
Mahan Doğrusöz: Thank you very much for your valuable contributions.
About Soley Sezgin Akten
Following her education at Saint Benoît French High School in Istanbul, Soley Sezgin Akten graduated from the Department of Guidance and Psychological Counseling at Boğaziçi University in 1994.
After beginning her professional career in the automotive sector, she went on to design and deliver leadership development, training, and coaching programs for managers across a wide range of industries.
As the founder of Physis Training and Consultancy, she has played an important role in introducing and promoting the Developmental Transactional Analysis approach in Turkey. A member of both the European Association for Transactional Analysis (EATA) and the International Integrative Psychotherapy Association (IIPA), she is also a founding member of the Eurasian Transactional Analysis Association.
Akten holds the designation of Certified International Integrative Psychotherapist (CIIP) and continues her professional development toward certification as an Integrative Psychotherapy trainer and supervisor. She works with adults, couples, and families in private practice and provides training and clinical supervision to mental health professionals.
She is married and the mother of two children.
