Institute for Integrative Psychotherapy

Integrative Psychotherapy Books

English language books by Richard Erskine may be ordered from Karnac Books at

Lynn Martin
Published in Self and Society Autumn, 2015

Relational Patterns, Therapeutic Presence:
Concepts and Practice of Integrative Psychotherapy

Richard G. Erskine
 Published by Karnac Books, London, 2015

I should begin with a confession that I am already a fan of Richard Erskine’s work as I find the Integrative model fits my own philosophy of working with clients. So I was not surprised to be delighted by this his latest book which I found has the same clarity that encourages me to think in a different way about my work with individual clients. Whenever I read theory I find my practice improves and never more so than when I read anything that Richard Erskine has written.

Relational Patterns, Therapeutic Presence is a synthesis of over 40 years of writing and development of the Integrative model of psychotherapy by Richard Erskine and I found a real maturity in the way his writings have come together so that the whole is much greater than the sum of the parts.

This is the kind of book that I need to read a few pages and then put it down whilst I process what I have just read. Having worked as a therapist for the past 25 years this book served as both a reminder and refresher of the theory as there is always a different perspective to be gained, particularly through the use of case material which helps me to review my working practices. This book will be equally useful for beginning counsellors and psychotherapists who want to work in a relational way. I have recommended this book to a number of my trainee supervisees and they report that they are thoroughly enjoying it.

Richard writes with such compassion and respect about distress that in other modalities is seen as pathological. For example, in my experience of working with clients who have been given a diagnosis of Borderline personality disorder they have often been given this label in a pejorative manner that has shamed them and led them to the conclusion that they cannot be helped. In this book, chapter 13, “Early affect-confusion: the “borderline” between despair and rage.” Is the first of 3 chapters detailing the psychotherapy with a woman who would fit the criteria of BPD. I find the skill and gentle potency with which the author addresses the client’s unconscious relational patterns and early developmental deficits a joy to read and inspirational for my own practice.

Most of the concepts in the book are not new yet in many places I found a new slant on the theory. For example, I am familiar with the theory relating to ‘script’, as will anyone be who comes from a TA background yet in chapter 6, “Life Scripts: unconscious relational patterns and psychotherapeutic involvement” the author describes an important aspect of script as follows, “Implicit experiential conclusions are composed of unconscious affect, physical and relational reactions that are without concept, language, sequencing of events or conscious thought” pg 97. Like so much of Richard’s writing I am left thinking, but of course! This makes complete sense. Why didn’t I think of this?

I was moved by his writing on cumulative trauma as it has such profound implications for parenting and for our therapeutic work with children as well as adult clients.

As I read this book I found my practice changing, as I am reminded of the importance of my therapeutic presence I become much more effective and I find my clients moving more quickly. This was particularly the case with chapter 11 which considers the theory of shame and self-righteousness which gave me a new perspective on one of my clients.

This book for me represents a maturing of the theory relating to an integrative psychotherapy. There is a deepening of the understanding of unconscious relational patterns that offers a way of working with clients that is respectful and compassionate, focussing not just on the client’s behaviour or thinking but also on the way that their story is revealed through every aspect of their being, including their bodily reactions, their relationship with self and others as well as the impact they have on the therapist.

This is a book that I will reread several times because I know that I will find something new each time.

Lynn Martin Published in Self and Society Autumn, 2015


The Institute for Integrative Psychotherapy is approved by the American Psychological Association to sponsor continuing education for psychologists, by the National Board of Certified Counselors for counselors and by the American Board of Examiners in Pastoral Counseling for pastoral counselors. The Institute for Integrative Psychotherapy maintains responsibility for this program and its content.