Weird rupture in alliance

Hi PCF,

I'm a MA-level clinical psychologist in training going under counseling (unrelated to my training).

We have a most peculiar kind of alliance rupture I can't put my fingers on. Perhaps this is quite simple and I just can't see the forest for the trees.

I've been in this private, self-funded therapy with my integrative therapist for about 100ish hours. We have an excellent rapport, excellent relationship. There is a sense of some shared interests (psychology, sports). I sense there is a deep and caring atmosphere for me, and I actually do care for my therapist. T couldn't take my caring well initially, but grew accustomed to.

During our last session T burst out in tears that therapy has to be done the correct way, and for T it looked like we're just talking like friends. I mentioned, I still have a great sense of development and movement in my life. I'm getting closer therapeutic goals. T couldn't accept me being content on the grounds that during the last couple of sessions we weren't professional enough.

It looks like as if professional conduct and my experience of helpful sessions are in conflict.

Shedding some tears T mentions the need of not being transparent and that boundaries weren't invented just for nothing. T kept referring to professional conduct. I was at loss for words, I couldn't reply with anything to comfort T. On my account, there weren't any boundaries violated. Or was it me, who violated, when I replied empathically to a T self-disclosure? Somehow this I doubt. There were a couple of boundary crossings though, so I can understand where T is coming from regarding not having completely sanitized sessions.

From my standpoint, this looks like a weird case of therapeutic rupture, where the break is coming from the expectations of the therapist instead of the client. I wonder how to continue? T emphasized how it's bad that we're talking like friends. T really wants to do a good job, but talking like friends is a no-no. It just occurred to me, T might think of me as a friend? Would it be the right thing for me to end the counselling sessions?

I can let go of me visiting T in the office, but it would be devastating letting go of the relationship. It is a great source of comfort and a powerful incentive of development.

I appreciate your thoughts.

It does sound like there is a friendship that is interfering with the process of therapy. Your T shouldn't be disclosing much personal info to you and she shouldn't be bursting into tears in *your* therapy.
What is going on there? Something has gotten muddled.

It sounds to me like your T might have developed some insecurities about whether she’s being a good therapist. I personally find a bit of self disclosure on the part of the therapist helpful. You describe it as being a weird kind of rupture, and I wonder if you have the expectation that ruptures would be ‘caused’ by the client. In my experience therapists tend to be imperfect and to bring their own insecurities or stuff to the relationship.

Could she being having a lot of self doubt.

Also, since you are training to be a counselor yourself, maybe she thinks she has to model a perfect by thr book theraputic relationship. Maybe she feels like by having looser boundaries whe is providing you a bad example of what therapy looks like.

While not a counselor myself, I work in a hospital psychiatric program. I saw a long term therapist who worked in my community. We often discussed the state of the mental health system in our state. She self disclosed quite a bit over the years. We had some sessions that very little hard work happened because I needed a break. Usually this fallowed some intense sessions. We saw it as continuing to build our theraputic alliance.

I’m sorry, what??

Your T is complaining about lack of professional conduct... how “boundaries weren’t invented for nothing” or “therapy has to be done the correct way” when THEY burst into tears?! Who is breaking boundaries here? That is not being very self-aware.

Your T seems to have major counter-transference. IF they want the relationship to be more ‘professional’, they ought to do some self-reflection themselves.

I don’t think you are the one who violated boundaries. Your T was in it too, and seemingly participated in this not-so-professional dynamic. The break seems to be coming from your T overextending themselves and where the boundaries became blurred for them.

He/she needs supervision and a good dose of self-awareness.

What is happening between you two seems to be more friendship-based and, unless your T behaves more professionally, I don’t see how it could be a therapeutic relationship going forward.

I also believe that your T is experiencing a major case of countertransference. It's pretty clear that she needs to consult her own therapist, or someone, for supervision.

T doesn't disclose much information. It's usually one or two things per session, related to my issue. It's been always something useful and I've often gave feedback on this. What happened I think it became too much to handle for T. T is overtly conscientious, which is pretty easy to pick up on, but disclosed a couple of sessions back nevertheless.

I think we got too close to comfort.

Yikes. When your T talked about "professional" and "boundaries," I think she was talking to yourself, not you. She clearly has a different sort of relationship with (or feelings for) you than is typical for her with clients, and it's making her uncomfortable and insecure. She definitely needs supervision, and perhaps her own therapist to help sort this out. It's not on you.

I am a T-in-training and my T and I have as a therapeutic goal to shift the relationship from client-therapists to collegial over time. This is a necessary goal, because our community is small enough that we already have overlapping relationships, we know many people in common, and we will run into each other in professional settings. So it's not wrong, per se, to have a therapeutic relationship that is atypical because of your shared profession, but this needs to be done carefully, thoughtfully, intentionally, and with transparency. And without your T bursting into tears.

Yes. T is very susceptible to such thoughts. T - on T's account - can ruminate on such minuscule things that makes T an obsessive character.

For me, T's disclosures were big of help, because I could clearly see what comes from who in the relationship. T is certainly not an ideal neutral surface that I could project to.

On the ruptures - there is a considerable chunk of literature on alliance ruptures coming from the client, but I haven't found anything that would cover ruptures caused by the therapist.

Oo, yes, this definitely has crossed my mind. T also knows about some of my cases, and that I'm in-demand to the level of exhaustion in my training classes.

Thank you for sharing this. It's nice to see how others feel this is normal, as T takes officially mandated recommendations of neutrality a bit too serious. We can see where that leads to.

I think T was very aware of that, but just couldn't take it anymore.

I think T has run out of energy to keep this contained. T didn't look very composed at the start of the session. Maybe T is overworked or something happened outside the sessions?

T might, but I think the real element is what scares T. I have a sense of our relationship being very real. Perhaps the process of that being scary reminds T of breaking the rules and feeling horrible because of that? That really might pass as countertransference.

I don't think T violated any boundaries. Certainly not mine. I just wonder whether we can continue as client-therapist at this point, or this is the end of this relationship. Our relationship is clearly taking a toll on T.

Actually I know T's supervisor, and I'm not entirely sure S would be of great help. We're from a smallish city, so we have like about 5 people both of us know personally, and about 10-20 both of us know professionally. I know S professionally, and S is not very good in handling transference issues.

Yes, I can totally understand this. How ironic that T is behaving unprofessionally because T's overt zeal to be professional.

My T self-discloses a fair amount with me, too, and we talk about why this is. The disclosures are helpful; I have no interest in a blank-slate therapist.

I personally do not love how the literature talks about ruptures, as if they are something that "comes from" the client. That's not how I see it. The rupture is in the relationship and the relationships is between two people (not belonging to either), it is co-created, and each person brings things to it. When we have ruptures, my T and both talk about how we each contributed to the dynamic at play. We, of course, spend more time talking about my stuff, because it is my therapy, but he owns his part in things.

YThank you Oliviab. My thoughts exactly.

Actually this haven't crossed my mind that this could be a valid therapeutic goal. Our community is small as well, and we have overlapping relationships too. We will definitely have encounters after the end of therapy, so why not end it well. Transparency is something really important for me...yet it makes T very anxious. I think it's T's issue. I hope T can get some help regarding this. I also think closing this in a nice and careful way might be an emotionally corrective experience.

As with some of the things you've already written - it's the same with me. It's empowering to read your comments.

Perhaps I wasn't careful enough with my wording, but I didn't intend to make it sound like it's the client's fault. It's just the therapist doesn't have such an empathic/relational depth to have foresight into what an interaction might mean for the client. I think it makes sense this way...and I would really love to repair this rupture, because I do care for T as both a person and a professional, but there's no such literature that would give any tools - or recommend intervention - from the client's part.

Regarding ruptures, I thought you were clear/careful in your wording and I didn't get the impression that you think it's all the clients' fault. I just think the literature--especially the psychoanalytic approach and the concept of transference--treat it as such. I was sharing (what I think is) some mutual frustration with you over that fact, and over the lack of literature about how Ts contribute to ruptures. I do see you taking on a lot of responsibility for repairing this rupture--I hope your T is taking on a lot of the responsibility as well. The two of you could do some really good work around this. And I hear you on wanting to end well, not just for the corrective experience, but to avoid future awkwardness in a small community. Good luck with this--I hope you'll keep us informed.

IMO your T should have taken their emotions and reactions to supervision... that is excellent fodder for supervision.
My T and I have an extremely strong relationship that does often feel like a very close friendship... except that it is confined to set therapeutic times, places and boundaries. We don’t go off meeting in coffe houses or visiting each others homes. We have a lot of common interests and we often share about them. I know a great deal of his family, hobbies and life outside the office. All of this has furthered my healing without a doubt. Some clients need their T to be a Dr in a lab coat that prescribes interventions to fix their emotional state. I need a relational human being that has set this time aside to join with me, sometimes guiding me, on this journey towards greater wholeness. Keeping with the journey theme it is like going on a long hike up a mountain... sometimes the trail is rough and you focus only on continuing up the mountain. Sometimes the ruggedness opens into a beautiful meadow with a cool breeze and you chat, perhaps pausing a moment to enjoy that spot on the journey... but you are still on the trail, still climbing the mountain. To say that such a beautiful rapport between therapist and client is unboundaried or detrimental is garbage.
My T often reminds me that the therapy is the relationship.

Ah, I'm so glad to read this. Yes, there are a couple of analysts using transference as a bludgeon, to have power over the relationship. It was pretty liberating reading the works of Greenson, Mitchell, Aron, Safran, Muran, etc. that not all psychodynamically oriented therapists share the ways of the neoclassical movement. (T is integrative, not clean dynamic, but has elements in the stack from the British object relations school)

Yes, T is very keen on taking the responsibility. Actually T is pretty zealous of taking responsibilities. T is an amazing therapist, who helped me overcome pretty harsh as well as hard-to-see difficulties in life. I have trust that we can resolve this, and I will post updates to this thread.

I'm very grateful for your responses. You are a really great help!

With the exception of boundaries - at least on my T's account - this could be said of our relationship as well. But it looks like the very close friendship part started bothering my therapist.

This is pretty relieving to read. I really do feel the same. But looks like this is a sign of unprofessional conduct on account of my T, and was the reason of T's collapse during our last session.

Being from an Eastern European country, I really do wonder if T has ever heard of Stephen Mitchell. Our newest textbook on psychotherapies, pressed in 2009 still has majority of its conceptual roots of papers from the 1980s. Of the newer textbooks we only have some Gabbard and Fonagy translated. Maybe Daniel N Stern does count? Having The Interpersonal World of the Infant translated was quite a big deal couple of years ago.

We don't even have an official name in our language for relational psychotherapy. About 90% of the things I read I have to do it in English.

It's a pretty exciting endeavor indeed! This time I'm more puzzled than emotionally affected by my current situation. I mean we're in a close enough relationship with T for me to believe that we can work this through. Either by continuing or closing the therapy. I'm open to either end.

And yes. Our rapport is definitely not unboundaried. I think where we go wrong is that when T does a self-disclosure T doesn't trust it's for my use. T starts self-doubting. Then makes up for it by giving extra time during the session. This T disclosed last sitting. I probably left off some details, as T was pretty vague regarding the time issue - mentioned the connection between the two, but also told, this slip with keeping time must be telling about something!

I find it interesting your T's stress around "doing it right". With everything that has happened in 2020, my T has opened up more. I have actually struggled a lot with having deep sessions. What has happened though is when I have those moments of deepness, my T goes pretty quiet.

In short, it seems she is following my lead, even when conversations are more like friends, she still has her T hat on and is ready for me to lead us into something deeper. When I make one of those more reflective statements or questions, she quiets down and changes how she interacts with me, it becomes more supportive, encouraging, and analytical.

She also subscribes to the belief that more causal sessions are there for a reason and does not discount the therapeutic value of them, even if the value is to strengthen our alliance.

Which leads me back to your T's stress around "doing it right". For a T, isn't "doing it right" all about focus and intent. If she feels you guys are simply talking like friends; isn't that more about her feelings and thoughts on your interactions, that she's losing that focus rather than what is being discussed or done in the moment?

The red flag I saw when I read your initial post and through the tread was how you might find yourself in the situation where the interaction start having moments of you being her therapist or supervisor rather than you being able/allowed to stay the client. It is a dance and it might be hard to see how things move through out the sessions and the relationship. I agree transparency and discussing what life might be once you have completed your therapy with her will be important since your community is small.

I think where my T is uncomfortable is that when our conversation are more like friends, T can't differentiate that with actual conversation of friends, because T acts very similar in therapy and outside of it. This closeness makes T significantly apprehensive.

My T wasn't really aware of therapeutic alliance as a concept. I guess this accounts from T training are still kicking somewhere around the 1980s in the country I'm from.

Though T is very intuitive in providing excellent therapy, on the conceptual level makes professional boundaries - by which T means the Freudian trinity of anonymity-neutrality-confidentiality. In T's head any breach from anonymity/neutrality is a technical mistake. When I say it's useful to me, or bring up its uses in non-classical psychoanalysis, T says those are important in Gestalt and CBT as well. Usually we stop there, as both of us understand, theoretical debates are not quite suitable in the therapeutic relationship.

Yes. It's her feelings and thoughts. But there's a preference on my side that T self-discloses, because I'm not very comfortable with neutrality. Still, there was a gray area which we could work together just perfectly. Now T disclosed more than T is comfortable with and broke down.

I put that on the account of T being such conscientious that would go even that far. Which makes me think, in spite of T's opaqueness and hiding, I really do know T. Yet this makes T uncomfortable -- because it's not aligned with classical analytic thought. Even though T is not a classical Freudian, but thinks that is the only professional way of doing therapy.

Yes. Whenever I meet anyone with the classical/neoclassical analytic approach, I automatically assume that person is out of his mind and tend to act like a person centered therapist.

I do not think this is at all appropriate. If my therapist burst into tears and shared what yours did with you, I would begin searching for a new therapist immediately. If possible I would also cease further therapy.

Normally I would probably do the same. But it looks like we're having a personal element to the relationship. And that's the very reason for T to burst in tears because T is uncomfortable with it. T thinks we can make this thing 'go away', and interact like in old times. I don't have problem with this personal element, as I don't work well with blank screens. If anything I get anxious and deeply isolated.

This might be that we're not a good fit professionally...but then, I've reached 4 pretty different goals with T in less than 100 sittings. And T is by far the best fit for me that I ever worked with. Maybe it's a personal fit.