Relational psychotherapy where connection becomes the cure
Relational psychotherapy in New York for people who want to understand how they connect, and to experience a different kind of relationship as part of healing.
We are shaped in relationship, and many of our deepest wounds happen there too. Relational psychotherapy works with that truth directly. Alongside exploring your partners, family, friendships and colleagues, we pay attention to what unfolds between the two of us. The therapy relationship becomes a living place to notice old patterns, try new ways of being with someone, and discover that closeness does not have to mean losing yourself.
“Insight alone rarely changes how we love. Being met, again and again, in a relationship that can survive honesty often does.”
Relational therapy offers understanding and experience together: you learn about your patterns and also live something new while you learn.
What relational psychotherapy looks like
Relational psychotherapy is a contemporary approach that sees the relationship between client and therapist as central to change, not just a backdrop for techniques.
Relational psychotherapy developed from psychoanalytic roots, attachment research and humanistic ideas. Its central insight is that we come to know ourselves through others, and that patterns formed in early relationships tend to shape how we relate as adults: who we trust, how we handle conflict, whether we can ask for what we need, and how we respond when someone gets close.
In relational therapy the therapist is not a neutral screen. I am a real person in the room, with my own reactions, and I am willing to think aloud with you about what is happening between us. When there is a misunderstanding, a moment of disappointment or an unexpected closeness, we do not skip past it. These moments are often where the most meaningful work happens.
Within my integrative practice, relational psychotherapy sits comfortably alongside psychoanalytic inquiry, somatic awareness and, where it helps, psychiatric care. Because I can also prescribe and manage medication, one consistent relationship can hold the whole of your treatment, which is itself a relational choice.
Rupture and repair
No relationship is free of missteps, including therapy. What matters is what happens next. If I say something that misses the mark, or you feel let down by me, we can talk about it openly and work it through. For people who learned that conflict means abandonment or punishment, experiencing a rupture that is acknowledged and repaired can be quietly transformative. Over time it builds confidence that relationships can bend without breaking.
Attachment and the nervous system
Our earliest bonds teach the body as well as the mind what to expect from others. You might feel your chest tighten when someone pulls away, or go numb when things become intimate. As a somatic practitioner I help you notice these physical signals in the safety of the therapy relationship, so your nervous system can gradually learn that connection can also feel steady.
Relationships of every shape
Relational therapy here welcomes every kind of relationship: monogamous, polyamorous or consensually non-monogamous partnerships, queer and chosen families, friendships, co-parenting arrangements, kink dynamics and professional bonds. We look at what each relationship means to you and how you want it to feel, rather than measuring it against a single template.
Relational therapy may help when connection feels hard
Relational psychotherapy suits people whose struggles show up most clearly with other people, or who feel deeply alone even when surrounded by them. You might know your patterns intellectually but still find yourself repeating them. This approach offers a place to understand those patterns and to practise something different in real time.
- Repeating the same relationship dynamics
- Fear of abandonment or rejection
- Losing yourself in partners
- Avoiding closeness or commitment
- Conflict that escalates or shuts down
- Loneliness despite many connections
- People-pleasing and difficulty saying no
- Family estrangement or tension
- Navigating open or polyamorous relationships
- Struggling to trust after betrayal
A relational approach that is honest and warm
My relational work is collaborative, curious and transparent. I aim to be genuinely present rather than detached, while keeping the focus firmly on you, and I bring in other tools from my integrative practice whenever they deepen the work.
The here and now
Alongside talking about relationships outside the room, we notice what is happening between us in the moment. How you feel arriving, leaving or being understood by me can reveal patterns more vividly than any retelling.
Mutual honesty
I may share how something you said landed with me, or wonder aloud about a shift in the conversation. This openness, offered with care, invites you to be more honest too and helps both of us understand the dynamics at play.
Patterns across a lifetime
We trace how early experiences with caregivers, siblings, peers and communities have shaped your expectations of others. Understanding where a pattern began often softens self-criticism and makes room for new choices.
Felt sense of connection
Relationships live in the body. We may pause to notice your breath, posture or energy when difficult topics arise, building awareness of how your nervous system responds to closeness, distance and conflict.
Context and identity
Relationships are shaped by gender, sexuality, culture, migration and power. My background in feminist thought and LGBTQIA+ care means we can explore these forces openly, including how they affect who you feel free to be with others.
Integrated psychiatric support
When anxiety, depression or mood shifts make relationships harder, I can assess whether medication or supplements might help. Any treatment is chosen together, introduced gradually and reviewed within the same trusting relationship.
Relational therapy and traditional models
Relational psychotherapy keeps the depth of analytic work while making the therapist a more active, visible participant.
Relational psychotherapy
- Therapist is a real participant
- Relationship itself is the focus
- Ruptures explored and repaired
- Two-way, collaborative meaning-making
- Change through new relational experience
More traditional approaches
- Therapist stays neutral and distant
- Relationship mainly a backdrop
- Tension often left unspoken
- Therapist interprets, client receives
- Change mostly through insight
Beginning relational psychotherapy
Like any relationship, ours begins with getting to know each other.
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1
Free consultation 15 minutes
A short call to share what brings you here and to get a sense of me as a person. Fit matters enormously in relational therapy, so I encourage you to notice how it feels to talk with me and to ask anything you want to know.
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2
Mapping your relationships 60 or 90 minutes
Early sessions explore your important relationships past and present, how you tend to respond under stress, and what you hope might change. If psychiatric symptoms are present, I can assess them as part of this fuller picture.
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3
Building the relationship
As trust grows, we begin noticing patterns as they appear between us as well as in your life. This stage is often where people first experience being seen without being judged, and where old expectations of others start to loosen.
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4
Carrying it outward
Over time, what you experience in therapy starts to show up in your other relationships: clearer boundaries, more honest conversations, steadier closeness. We review progress together and plan any eventual ending with the same care as the beginning.
Francesca Rome-Marie, PMHNP-BC
I bring together psychiatry, psychotherapy, somatic work and whole-body health, informed by years in primary care and further study in gender theory, feminist thought, culture and visual art.
I keep a deliberately small caseload so that every client receives consistent, unhurried and genuinely attentive care, held within one relationship rather than split across several providers.
Clear, upfront rates
I don't accept insurance. Modern Holistic Psychiatry is an out-of-network provider, so sessions are paid for directly. Depending on your plan, you may be able to claim reimbursement through your out-of-network benefits.
Find out how much your insurance may coverNeed urgent support? If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
Relational Psychotherapy FAQs
What is relational psychotherapy?
Relational psychotherapy is a form of talking therapy that sees human beings as fundamentally shaped by relationships, and treats the therapy relationship as a key place where change happens. It draws on psychoanalytic, attachment and humanistic ideas. Rather than the therapist staying detached, both people engage openly, and what happens between you becomes material to explore. In New York I offer it as part of an integrative practice that can also include somatic and psychiatric care.
How is relational therapy different from couples therapy?
Relational psychotherapy is usually individual therapy focused on how you relate, rather than joint sessions with a partner. We explore your patterns across all your relationships, and the therapy relationship itself, so you can bring new awareness to your partner, family and friends. Many people find that individual relational work changes their partnerships significantly, even without the other person attending.
Will you share personal things about yourself?
Relational therapists tend to be more open than traditional analysts, but the focus always stays on you. I might share how I am experiencing a moment in our conversation, or acknowledge if I have got something wrong. I am thoughtful about what I disclose and why, and I only share when it is likely to help the work rather than shift attention onto me.
What if I struggle to trust therapists?
That is common, and it is welcome as part of the work rather than an obstacle to it. Relational psychotherapy moves at a pace that respects your caution. We can talk openly about what makes trust hard, including previous experiences with therapists or doctors. Many people find that slowly building trust with me becomes one of the most healing parts of therapy.
Is relational therapy suitable for polyamorous, queer or kink relationships?
Yes. I work in an affirming, non-pathologising way with all relationship structures and identities, including polyamory, consensual non-monogamy, kink and BDSM, and queer and trans relationships. We focus on what you want from your relationships and how they feel, not on whether they fit conventional expectations. You will not need to explain or defend how you love.
Can relational psychotherapy be combined with medication?
Yes. As a board-certified psychiatric nurse practitioner, I can assess whether medication might help with anxiety, depression or other symptoms affecting your relationships. Because the same person holds both therapy and medication, decisions are made within a trusting relationship and with full context. Any changes are gradual, collaborative and carefully monitored, and you remain in charge of your choices.
How long does relational therapy usually last?
It varies widely. Relational change takes time because it relies on building and experiencing a relationship, so many people work with me for several months or longer. Some come for a focused period around a breakup, family rupture or transition. We review together regularly how things are going, and you can always adjust the frequency or decide to finish.
Start relational therapy in New York
If you are ready to understand and reshape how you connect, book a free 15-minute consultation and see how it feels to talk with me.