Psychotherapy Beyond Words

Abstract

This article is based on a keynote address delivered at the 12th International Integrative Psychotherapy Association Conference (Ljubljana, Slovenia, May 8, 2025). It explores the proposition that the therapist’s state of being, beyond technique or verbal intervention, plays a central role in the therapeutic process. Drawing on contemporary research in physiological synchrony, the author highlights the bodily and physiological dimensions of psychotherapy, with particular emphasis on physiological attunement and the therapist’s embodied presence. Physiological attunement is introduced as a newly defined sixth component of the Keyhole model of integrative psychotherapy (Erskine et al., 1999/2023; Žvelc & Žvelc, 2021). The article argues that mindful awareness and self-compassion support therapists in regulating their autonomic arousal and conveying cues of safety to clients, which are key factors in fostering effective therapeutic involvement. A transcript from a therapy session is included to illustrate psychotherapy beyond words. In the final section, the author reflects on broader relational fields that support healing beyond words, drawing inspiration from Māori perspectives on interconnectedness, nature, and ancestry. It concludes with a guided practice, inviting readers into embodied, compassionate presence.