Psychotherapy and the dialectics of hope and despair

The importance of hope in healthy human functioning is increasingly recognised within the psychotherapy literature. It has been linked to a range of positive health outcomes, both physical and psychological, and is acknowledged as one of the key common factors of therapeutic change found across theoretical approaches. However, not all commentators agree that hope is of unquestioning benefit. For some, hope only serves to maintain psychological confusion and for others its promotion obscures the reality that despair can also serve a necessary function within psychological change. This article explores the notion that both hope and despair are active ingredients in the change process and often exist in a dialectical relationship. The therapist's capacity to embrace both hope and despair within the therapeutic relationship is explored.