This is a topic that many of us know so well and to others it is alien. There are so many different types of ruptures and various different reasons.
I am guessing that many will depend on the client and therapist, their different backgrounds/ personalities and many of them occur because of circumstances and therapeutic interactions.
I have been thinking a lot lately about mine and my ts many many ruptures and can identify a few reasons. Our most recent rupture was because of her disclosures, her pacing and counter transference . Most of our ruptures stem from a serious of empathic failures, some small and others unforgivable!
I am curious to know how your ruptures began in therapy and were they eventually mended/ forgiven?

[Out There]

My T and I have had them when he pushes a bit and forgets I'm still not very well. He doesn't hit the wrong notes that often but when he does he really does. But he's psychologically mature ( which I'm not used to ) so we've managed to sort them out , but they do make me feel like leaving therapy.

I really don't think we ever had any ruptures. Sure, there were times we weren't in agreement about things, but we just talked about those things in the moment and moved on. Nothing I would even begin to classify as a rupture.

[LonesomeTonight]

I feel like mine with both T and marriage counselor were when it felt like something was offered or promised to me, then was taken away with what seemed like a unilateral decision by the T (future individual sessions with marriage counselor, unlimited e-mailing with T). Though each was a bit more complex than that, particularly with T. I think in both cases, it triggered fears of abandonment going back to my early years.

I got through both of them, but it took a few weeks to a month or two. And it would be like, I'd leave a session thinking, "OK, I'm good with everything now," then a few hours or a few days later, would realize that I wasn't OK. That there was more that needed to be discussed. In each case, I was able to move past it due to some combination of the following: T or MC admitted that they had made a mistake, that they'd offered something they shouldn't have, that they'd been unclear, that they felt bad about what happened, that they understood why I was upset. Had they just remained defensive and insistent that they were right, without trying to understand my perspective, then I don't think I could have moved past it.

Incidentally, the ruptures in both cases were very intense to me, with a feeling almost as if my heart was being broken, even with a physical feeling in my chest along with the emotions. That suggested to me that they were tied to childhood stuff because of the intensity. Considering that I have some transference for both, it makes sense.

[here today]

The ruptures I have had in therapy all boil down to the same thing and the final one with the last T was not repaired, nor is my "relationship" with therapy in general -- I 've done my best with a bunch of different therapists -- whatever my problems were and have been, I think the strategy of rupture and repair was bogus in my case.

All the ruptures boil down to me believing that therapy was a place where I was supposed to say how I felt and when I was angry with a therapist it was too much for them. Several, including the last one on several occasions, got huffy and put me down and shamed me. Which I immediately took on myself, part of a lifelong pattern.

The main problem, I believe, is that I didn't develop a healthy, integrated identity or idea of who I am/was as a real person as a child/teenager/ young adult. All the old clichés -- false self, trauma, etc. It's hard to say what my life would have been like without therapy but to end the last one with the T once again putting me down and then, finally maybe?, me returning the favor? -- well, "payback" is an odd kind of "repair" and not a very satisfactory one at all but maybe sometimes. . . Reality is not ideal. :-$

[mindwrench]

My last T blew it by being rigid, cold, and robot like yet expecting me to trust him and follow his treatment plan, dismissing my issues. I'll only give so much before I shut it down and sever communications under those conditions. To hell with him!

[fullsassahead]

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.

[atisketatasket]

I had constant ruptures with No. 1 because she was just irritating as all get out.

I had a really serious rupture with No. 3 when she let me go at the end of a session in a very disturbed, unsafe state, to which she had contributed. And then when we talked about it later, she screwed up the apology big-time.

[growlycat]

With my long term t the first five years were ruptures. "You don't care about me I quit,". Then t would call me and reassure me then we'd work it
T out. It took years until the ruptures were further apart.

With Sparky my only true rupture was early on when he was helping me with the driving phobia. It was close to the end of session time but we were not close to being back in the office still on the road in my car. I missed a right turn and he raised his voice at me "turn here!" Which made me jump out of my skin. He sounded angry too. I almost dumped him curbside to walk back. Amazingly we worked that one out. Sparky knew he screwed up and owned it like a champ

[therapyishelping777]

never had any ruptures with my T

[Petra5ed]

I had one months back and am still in the midst of it. Yes,empathetic failure. In my case it's still ongoing because if I try to address it he suggests I see a new therapist. Pathetically I continue to go even though the connection is gone.

Originally Posted by fullsassahead

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.

Wow, your t sounds pretty amazing and I am sure that your relationship grew stronger after this happened. I like the way your t was so open and acknowledged what you BOTH could have done differently. This is where the healing lies. I believe that a client is never to blame or responsible for a rupture. It is a therapists job to model how healthy conflicts can be resolved safely and maturely with both parties being allowed to voice their opinions.
This is where my t fails, she talks over me, doesn't agree that her lack of empathy is the source of my pain, etc etc.

Originally Posted by LonesomeTonight

I feel like mine with both T and marriage counselor were when it felt like something was offered or promised to me, then was taken away with what seemed like a unilateral decision by the T (future individual sessions with marriage counselor, unlimited e-mailing with T). Though each was a bit more complex than that, particularly with T. I think in both cases, it triggered fears of abandonment going back to my early years.

I got through both of them, but it took a few weeks to a month or two. And it would be like, I'd leave a session thinking, "OK, I'm good with everything now," then a few hours or a few days later, would realize that I wasn't OK. That there was more that needed to be discussed. In each case, I was able to move past it due to some combination of the following: T or MC admitted that they had made a mistake, that they'd offered something they shouldn't have, that they'd been unclear, that they felt bad about what happened, that they understood why I was upset. Had they just remained defensive and insistent that they were right, without trying to understand my perspective, then I don't think I could have moved past it.

Incidentally, the ruptures in both cases were very intense to me, with a feeling almost as if my heart was being broken, even with a physical feeling in my chest along with the emotions. That suggested to me that they were tied to childhood stuff because of the intensity. Considering that I have some transference for both, it makes sense.

Every rupture I have had with all of my ts it has felt like heart ache a huge loss. It's definitely a young place for me, I feel like a little girl again who has been abandoned and left to process it all on my own.
I am glad that both your t and mc were able to own up to their part in their mistakes. This really makes a lot of sense that the clients who have suffered the most trauma and neglect in childhood would be so upset when their t abandons them either emotionally or by taking something away that they had promised or even by promising something they can't commit to, it's repeating a a childhood pattern that our parents laid the foundations for. I know that empathic failures are the hardest for me because my mother was never empathic and never tried to resolve or understand anything. It was always her way or the highway, t doesn't really take this into account when she doesn't understand me or misinterprets something I said. She can't hold either my anger or my sadness because her own feelings get on the way. It makes me very sad as I think we could both learn and grow from this rupture if we could resolve it together.

What's a rupture?

All the ruptures I've had with T have been around him missing my needs in some way. I'm little worried we could have a rupture over T1 because sometimes he struggles to know what I need from him with regard to T1. I'm just hoping he gets it right, and isn't dismissive or minimising. A rupture is much more likely on a subject I'm sensitive about, like this one.

Are we talking about cracks in the theraputic consistency?

[growlycat]

I think it is also called misattunement

Originally Posted by growlycat

I think it is also called misattunement

But, this **** needs to happen in therapy. How can one learn to trust a relationship if it had to bear fruit constantly. It's the repairing together that's worth more than it never happening.

Originally Posted by _Mouse

But, this **** needs to happen in therapy. How can one learn to trust a relationship if it had to bear fruit constantly. It's the repairing together that's worth more than it never happening.

Not everybody is in therapy to learn how to do relationships though. So it is useful to some people (me included) but not everyone.
Also, the functionality of ruptures in therapy is dependant on the competence of the therapist. So ruptures with T can be enlightening but ruptures with T1 were just distressing.

Originally Posted by Echos Myron

Not everybody is in therapy to learn how to do relationships though. So it is useful to some people (me included) but not everyone.
Also, the functionality of ruptures in therapy is dependant on the competence of the therapist. So ruptures with T can be enlightening but ruptures with T1 were just distressing.

If relationship wasnt important, than the ruptures wouldn't carry the weight you are saying they did.
Of a T just isn't up to the job than its not so much a rupture, as an unskilled/incompetent therapist. There's 2 different issues there

I agree with Echos, not everyone is in therapy (even in psychodynamic therapy) to work on relationship issues or at least it is not always the main goal or focus for a client. I am one of these, for example. I had constant conflicts with my former T during the last couple months of our work together and while it was enlightening in a few ways regarding my needs and values, it was quite destructive at the time given that I had a much bigger problem that I really struggled with and that he mostly ignored (a relapse with an addiction) and kept pushing his agenda. It made everything worse.

I think that many therapists like to explore relationship issues by default, it is something that is ingrained in the profession. But it is not always what benefits the client best in the context of what they want from therapy. With current T, I started seeing him primarily to work on said addiction issue plus some anxiety related to work performance and I have become used to regularly reminding him to stay on track. He does have a liking for relationship stuff and I like to discuss those things at times but not as a main theme. He is generally very compliant with what I ask of him and agreeable. We have been working together for ~5 months now and never had a rupture -- I am thankful for that because working on conflict resolution is not what I am in therapy for now. But I feel that the quite smooth therapy relationship we have helps me a lot to address my primary concerns and as a "side effect", I am actually learning how to manage and maintain a good professional relationship (something that comes handy in my job). I have a feeling that my T may be a bit conflict avoidant (beyond just treatment design) but if this is true, it serves me well. I think it would not help me to have a stressful therapy experience right now.

[Myrto]

I've had a big rupture a month ago: my therapist told me I was harassing her and she completely changed her boundaries. I'm no longer allowed to email and if I do, she'll cancel the next session. I've tried to find another therapist but they were either too expensive for me or didn't have any available slots. I went to see one other therapist and when I called to make a new appointment (left a message), she never called me back. So I gave up and decided to stay with my current therapist. Where else would I go? She acts like nothing happened so is this even a rupture? I think we are never going to fix this because she is never going to acknowledge that what she did was wrong. Ruptures can be talked through but if one party acts like it wasn't even a rupture, well, what can you do?

[Argonautomobile]

I think a genuine apology goes a long way. Isn't that a thing in healthcare risk management, that the provider should own their ****-up and apologize rather than getting defensive, and they're, like, a billion per cent less likely to get sued?

I don't know if "rupture" is really the right word, but I've certainly been pissy at my T and felt hurt by his egregious lateness and general unavailability. Once he left for twenty minutes, in the middle of the session, to attend to another patient in crisis, and did not make up the time at the end. Another time he was 45 minutes late, and also did not make up the time. He apologized both times, was suitably chagrined, and it was genuine enough to mollify me.

I don't really view these as empathetic failings, just institutional strain and (at worst) a touch of laziness. Or maybe just **** time management. I don't know what I would have done if my T had ever acted like your (now former) T. I really hope the new one works out. Good luck, MLS.

[LonesomeTonight]

Originally Posted by Myrto

I've had a big rupture a month ago: my therapist told me I was harassing her and she completely changed her boundaries. I'm no longer allowed to email and if I do, she'll cancel the next session. I've tried to find another therapist but they were either too expensive for me or didn't have any available slots. I went to see one other therapist and when I called to make a new appointment (left a message), she never called me back. So I gave up and decided to stay with my current therapist. Where else would I go? She acts like nothing happened so is this even a rupture? I think we are never going to fix this because she is never going to acknowledge that what she did was wrong. Ruptures can be talked through but if one party acts like it wasn't even a rupture, well, what can you do?

I think it can definitely be a rupture even if the T doesn't think anything happened. If it's upsetting you and negatively affecting your relationship with and trust in your T, then it sounds like a rupture to me. I'm sorry you haven't had luck finding a new T. Maybe try the one who didn't call back again--could be the message never got to her or something. Yours just sounds so punitive with the whole "If you e-mail me, I'll cancel the next session" thing. I don't see how that's helpful.

Yes, I agree not everyone goes to therapy to work on relationships and not every t wants to work in this way by using the relationship as a tool. So it very much is an individual and circumstantial thing.
I never went to therapy to work on my relationships but current t really likes to talk about what is happening between us at any given time and I have learned a lot about my behaviour and the triggers behind my reactions to her and sometimes even acknowledging these triggers can cause ruptures.