Yes, and…I strongly believe that without an attuned relationship the change can’t happen. The trouble is that we see care typically as warmth and nurture only. Sometimes attunement is playful aggression. Sometimes it is tolerating the feelings of uselessness. Sometimes it is in challenging a patient to consider their position or resistance. I would like to think of all of those positions as care. But I am a big Object Relations and Modern Analysis geek. I know we get criticized as the “touchy feely” therapists. But I think there is solid evidence to support the often intense and brave experience of meeting unmet relational needs.