How does your therapist handle ruptures?

Not at all. In my look at several studies, as in all things studies, the methods, results, interpretations, varied widely. One of the things this particular study talked about was the difficulty in studying therapy because nothing was particularly stable. Even between two therapists using the same methodology, their techniques vary, the clients vary, the results are dependent on level of experience, etc., etc., etc. It is a very inexact field that way.

I haven't read any studies, but my personal experience aligns with the results that show therapists report fewer ruptures than clients do. Almost to a person, each therapist I've had was always surprised that I'd been upset or struggling with a therapy interaction for a period of time. With the one I see now, she sometimes says, "You've brought this up before." Or, "Is this still bothering you? I thought it was resolved."

I've had a couple of what I think T and I would both call ruptures. In all cases, it stemmed from me bristling at feeling like he was trying to direct me to act a certain way and me not feeling comfortable at all with it.

He handled these incidents beautifully--hearing me out, apologizing for his role and discussing how we might have high contributed to the break, and then reassuring me that his goal was never to direct me to do anything. I felt heard and respected and like I was ultimately in control of my life and my therapy.

Wow...nice discussion!

So, my therapist has explicitly said -- repeatedly -- that the relationship with her is / should be key to my 'healing'. And, that while everyone may not need it, given my particular set of issues, she believes it's the relationship that'll matter. She brings up the relationship with her no matter what other relationships I'm talking about (friends, family, lovers etc) and asks how that particular stuff I'm talking about would apply in my relationship to her. She's also repeatedly questioned as to how I can't seem to see that she cares beyond her professional competence -- it seems to be one of her pet peeves with me.

Having said that, in my not-so-humble opinion, she has SUCKED at dealing with ruptures (fitting the definition lolagrace provided earlier)-- and yes, she has used the word ruptures and like Unaluna's T, has mentioned that it's repair that's important and not the ruptures themselves. Except I don't feel like any one of our ruptures -- of which there have been two major ones and plenty of not-so-minor and minor ones -- have ever been resolved.

I have brought them in the session itself + the next session + in the next few sessions + much later and to no avail. Her response is either silence or blaming it on my mother or total memory loss ('Can you jog my memory about what happened?' even thought it was the previous session and her memory's pretty solid in general). And, nothing ever changes really.

So, yeah. I have no idea what to make of it.

In terms of the articles about ruptures etc -- the couple I've read actually fit parts of what both lolagrace and stopdog mentioned. So, therapists did mention more ruptures but they also rated the alliance much higher than clients did. Then again, I have not by any means done any serious lit search on it -- so, can't really speak to it.

Personally, my experience is somewhat similar to ruh roh's -- T doesn't think there are any ruptures when I actually say I'm upset etc and it ends up going absolutely nowhere.

At this point, it's not even about my hurt feelings or anything related to my emotions. I have begun to wonder if it's a matter of skill / competence with her after all -- in general, as well, I think I used to tend to primarily give importance to how I felt when ruptures happened but more and more, I'm beginning to think that regardless of any emotions involved on the part of either the T or the client or even the strength of the therapeutic alliance, it's just skill and experience of the T that matters in how they handle ruptures......or, maybe not.

To sum up, this stuff drives me crazy -- it feels like it's a part of Therapy 101 and I can't believe that my T who is otherwise rather insightful and has helped me in measurable ways, keeps f-ing up on something so basic. It's mind-boggling honestly. With a T who generally sucked, I would have no trouble believing that they also f-up how they handle ruptures. But, I truly can't understand how someone who otherwise knows their stuff, can falter repeatedly in this rather basic aspect.

It's crazy making. I've been wondering (and maybe you can relate, awkwardly) if some of it has to do with the fact that I question my therapist a lot, in a way that looks like arguing, so maybe she can't tell what a rupture is because I easily question or object. The other day, she said something and waited. I waited. She chuckled and resumed talking. I stopped her and asked why she had laughed, and she said she'd been waiting for me to argue and was surprised when I didn't. And later, I thought she looked scared of me, and she said no, she was sad...that what I'd said made her sad. And I said well, you looked scared. And she said maybe I was seeing things in her that were more about how I feel. So she sort of had a good point with that one.

Now I am wondering if, in my case at least, I have worn her down to such an extent that she can't see what I consider big ruptures even when I point them out. I should be glad she at least stays in the game, even if I'm having to conduct one sided ruptures.

Awk, I don't suppose she could be doing that thing they do where the "healing" takes place not in the relationship itself but in the interaction? In other words, she's acting the way a lot of people act when they are at fault. And she thinks you need to learn to deal with that, not the actual rupture?

With the two ruptures, and even with the locker room incident, which I don't consider a rupture, No. 3 always says "we can talk about it as much as you want." Is this not a common approach? Because it seems like a reasonable approach to me.

YES! She's repeatedly talked about my questioning as if it's some awesome, amazing thing that is a sign of my terrific mental health. But, doesn't everyone routinely question the therapist? It's a bit weird that she doesn't seem to think it's the norm.....unless she's pulling one over me.

But yeah, I totally agree that the questioning can seem like arguing (which I've been told by other folks as well to my bewilderment) and so the scale of the rupture may not be obvious -- hadn't thought of it that way.

And yeah, I do get the stuff about projecting things in terms of how we see it. Argh.

Btw, I don't think you're in any danger of wearing down your T!

Oh wow...that does make sense but I really wish she'd just say it then. And, the painful part is that someone totally denying or minimizing stuff (which in my family's case reaches utterly ludicrous levels) is exactly what is so awful about my past and something I'd like to change.

Your no.3's response sounds terrific (I'd totally brave the locker room rendezvous for a response like that!) and no, that seems to be a very uncommon thing to do, in my experience.

A doctoral thesis - but starting on page 42 it has an interesting description of rupture and how therapists can make it worse and a description of how they can try to directly or indirectly attempt a repair and gives cites if one wishes further info from the source.

http://www.davincilearning.org/sketc...in_therapy.pdf

Madame T was all, "You chose to leave. You chose to come back. It's nothing at all to do with me."

Madame t was a defensive jerk.

Mine handled it really well. I am not sure I would call it a rupture but she said she would do something and she didn't. I was annoyed but couldn't tell her for about 3 sessions. I wasn't emailing her because I couldn't if I couldn't tell her I was annoyed. It was like going round in circles so one session I promised myself I would say nothing until those words came out and we spent about 15 minutes in silence. She persuaded me to the desk and we tried to draw but nothing. I finally wrote 'I am annoyed' and we spent the session just working with that. Not much got done but it was important just to get that out there. The next session I managed to write that I was annoyed with her. She asked me if I could help her to understand why and so I wrote that down. She said so gently that it had been brewing for a while now and that she was sorry and she explained why, saying it wasn't an excuse but that I deserved to know why. We spent the entire session with me being silent this time, I just wrote everything because I couldn't talk, I was terrified and shaking, just literally holding myself together. I wrote that I was sorry and she said that I had nothing to be sorry for, it was her who had done wrong. She was patient and apologised one more time at the end. She said I had taught her a very valuable lesson, in a nice way.

I think next time it might be easier to use my voice because of how she responded to me that day.

Mine makes excuses, runs away and hides hoping no one else will find out. He has no experience so I shouldn't expect much right?

Four years with no ruptures, then the first time I criticize him he responded by being mean. I was shocked and mortified. No apology. So I'm going to say poorly.

It has the effect of making me feel like I don't have to talk about it anymore...because I can bring it up again any time I like.

Therapy...or mind trick? Dear reader, it is for you to decide.

ugh, that's terrible!

He should take that up with his supervisor. And if he doesn't he's not doing his job.

Mine puts our relationship as the main goal to "heal" so he handles ruptures well. Always takes responsibility and will make changes. We talk about it forever the few times I've gotten the courage up to tell him I was mad at him. To me it's really weird that he's tolerant of me being mad at him and wants me to share that.

I didn't answer as I don't think we have ever had a rupture. Sure there have been times when she has done or said something that upset me. However, it has never gotten to the point that I feel like it has stained our therapeutic relationship. I mention whatever upset me she usually apologizes for not being clear about what she meant and explains herself better. I know she would never intentionally upset me. I also have come to realize when something she says or does upsets me it is because it usually triggers an insecurity I have.