Dependency and power in therapy according to John Steiner

The article analyzes the paradox of the therapeutic process, in which clinical improvement can lead to the destabilization of the relationship. The author refers to John Steiner's concept, pointing to the phenomenon of the "narcissistic cost of improvement"—the moment when a patient, regaining their functioning, must confront the fear of dependency and the loss of the illusion of self-sufficiency. Accepting help is sometimes experienced as humiliating, which triggers defense mechanisms such as the devaluation of the therapist or the transformation of shame into indignation. The text emphasizes the difference between the institutional asymmetry of the relationship and a pathological understanding of dependency in terms of dominance and submission, highlighting the key role of secure attachment in building the therapeutic alliance.