Interesting topic. And, certainly one I don't typically want to think about, but, nevertheless, is important.

My current T and I have not had many ruptures. In fact, there is just one that I can think of. And, it was more one that I felt versus one that she acknowledged as a rupture on her end. About a month ago, I texted for support and set the ball in motion to cause a rupture. I have an eating disorder and have been quite sick for some time. I need a higher level of care, but one cannot be accessed due to insurance and finances. So, we do the best we can. When I texted her, I disclosed that I had been struggling with something in particular. She misunderstood what I meant and came back with a recommendation that I do something specific. Her request, in my eyes, was ridiculous and ludicrous considering where I am at physically and emotionally. But, she said it was a non-negotiable and I know, with her, that she means business if those words are used. I railed against her and threw out every reason why I couldn't and wouldn't do what she asked of me. And, she stayed firm and consistent - she said she wouldn't negotiate with me over it. I had an absolute meltdown. Like, seriously lost it. I acted out and was just completely out of control. I did and said things that I knew were upsetting to her, but my actions really only hurt myself. Because of how over-the-top I had gotten, I caused all members of my team to have a crisis meeting. It caused a lot of unrest for everyone. And, being as I was set to see my therapist the next evening, I was afraid of her reaction. I made up all sorts of scenarios and threatened to quit because I couldn't tolerate it if those scenarios truly came to pass. My meltdown lasted more than 24 hours and I was sure I had done irreparable damage to my relationship with my T. In the end, I wound up going to her office and she welcomed me with open arms. She looked at me and gently said that we would get through this; that I had not done anything so bad, so terrible. She reassured me and then acknowledged the emotions that came up for me the night before. She said she felt badly too, but that she could not negotiate something that was so important. I feared her taking away text support and that did not happen. She asked me what she could have done differently and then asked what I could have done differently. And, we have been working on those things since then. If anything, the situation strengthened our relationship as I learned that she wasn't going to go running just because things were difficult or uncomfortable.

Previous ruptures with previous therapists did not end as positively. I believe it depends on each client and their experiences, beliefs, and emotional/physical health. And, the overall health of the therapist as well. A T who is competent, emotionally intelligent, and who has healthy boundaries will be able to work with a client to repair ruptures. I'm thankful to have seen that with my current therapist. But, with previous therapists, I've seen a rupture be something that we couldn't come back from. And, in those situations, I don't believe I was solely to blame. Any relationship will have its strains, but what's important to remember is that it takes two to cause a rupture and it takes two to repair one.