[SarahSweden]

I don't have any actual figures on this but it's for sure a lot that points to my conclusion. I know some countries have a referall policy and that's one thing. But I believe most therapists will leave their clients when being criticised or when clients behave in a difficult way.

Some will refer the client, some will just abandon them. Reading on this forum and many else tells me abandonment, ruptures and termination belongs to one the most common topics.

I think many clients hope their therapist will miss them, will regret what they did, will think of them afterwards but I doubt the therapists actually do that. Of course some will but I think many of them become desensitised and whilst the client mourn and grief for months and sometimes years most therapists will just take on a new client to fill that empty slot.

Some "super therapists" will for sure act by the book, try new methods, accept clients' critique and so on but I believe there are very few who has both skills and conscience for that.

With other mental health care stuff I believe it could be even worse, they lack therapeutic skills and have even less tools for avoiding ruptures and so on.

Some even say that mental health care is dangerous to vulnerable people who are dependent upon their therapist and doctors.

[atisketatasket]

Keep in mind the population of those who post on online forums about therapy is small and self-selected. Reliable statistics can’t be extrapolated from a sample like that. Certainly not enough to say “most.”

My own experiences as a client and reading on here suggest a far more mixed conclusion. Sometimes therapists leave, sometimes they don’t. Sometimes the client leaves. Sometimes both stay but the relationship is broken. Sometimes it heals and is stronger. Sometimes therapist and client part by mutual agreement.

But anecdata is almost worthless to support the point you’re making.

ETA: not, of course, dismissing anyone's individual experience.

[HarperF]

Originally Posted by SarahSweden

I don't have any actual figures on this but it's for sure a lot that points to my conclusion. I know some countries have a referall policy and that's one thing. But I believe most therapists will leave their clients when being criticised or when clients behave in a difficult way.

Some will refer the client, some will just abandon them. Reading on this forum and many else tells me abandonment, ruptures and termination belongs to one the most common topics.

I agree. I'm currently training to be a therapist (2nd year of PsyD). We just don't get trained for critical scenarios that way. We get trained well to tell organic and mental problems apart. When to refer someone to a psychiatry or a blood test.

On how to negotiate actual ruptures...very few material is available. Most of my classmates are not interested in such topics, and they think I'm overly cautious and think I would be the first to burn out. Usually it's just "get supervision when it's a current issue, duh". But then, I'm not sure how getting a supervision would work out for therapists if they face an issue they never prepared for. Supervision is not a magic pill.

Originally Posted by SarahSweden

I think many clients hope their therapist will miss them, will regret what they did, will think of them afterwards but I doubt the therapists actually do that. Of course some will but I think many of them become desensitised and whilst the client mourn and grief for months and sometimes years most therapists will just take on a new client to fill that empty slot.

I would disagree on the desensitization. Most of the therapists I know don't take such things lightly when they actually happen. But it's rare to happen. Of course they can't afford to be invested in a relationship as deeply as their clients, so it's much easier for them to think about a rupture that they weren't a good fit and it's for the best that they parted ways. Usually this is their consolation.

Originally Posted by SarahSweden

Some "super therapists" will for sure act by the book, try new methods, accept clients' critique and so on but I believe there are very few who has both skills and conscience for that.

What's troubling me is that there is no book on this. There is no consensus. Some writers even encourage being cold and professional about such things. Client should be referred somewhere else and that's about it.

[here today]

That therapy is dangerous was certainly my experience.

It can be seen clearly with people who were sexually exploited. But I now believe that I was -- and perhaps other people may be -- especially vulnerable to what I call "narcissistic exploitation", because of my early life and experience, not all of which I knew about or could reasonably be expected to know about, I think.

It doesn't have to be that the therapist is a "narcissistic", or be conscious of what they are doing, just that she/he learned (from their early life?) how to get self-esteem gratification by "helping" people or by being an expert or by living their lives vicariously -- or many other possibilities. These are, theoretically, taken care of by the therapist's own therapy -- but far too often they are not.

Which leaves some of us vulnerable to playing into those needs of the therapists. My instincts about that kind of thing were numbed out, because of the family I grew up in, and numbing out was something that left me LESS vulnerable in that situation. Unfortunately, like in lots of life, that past pattern made me MORE vulnerable in other situations. Like therapy.

When the therapist's issues are triggered in therapy, and are too much for them, and there is a rupture which they can't repair on their side -- then, yes they may terminate the therapy. They can't bear it. They can't deal with it. They don't have "the emotional resources" to continue, as my last therapist said. What seems not be recognized as an issue in the therapy profession is that this kind of termination can be DEVASTATING to some clients -- it certainly was to me. And, OK, maybe that's because it was issues that I came into therapy with that made it so bad -- but, isn't that the point: I CAME INTO THERAPY WITH ISSUES, SOME OF WHICH I DIDN'T KNOW ABOUT, IN ORDER TO GET HELP. And instead got hurt.

[nottrustin]

I suspect the information here is quite slanted. I can honestly say my T encouragea me to tell her when she screws up. We discuss it and work through it. It has never gotten to the point of a big rupture because we work through it. One of the things I know is her intentions are never to hurt me. She apologizes profusely.

this week I brought something she says that bothers me. While I told her before, she never undertook it. This is a something that is always said and normal it just bothers me. I could tell that it bothered her initially. We discussed it I explained why it bothers me. She apologized and told me to please call her out if she uses the term and she is going to make a huge effort not to.

[NP_Complete]

I can't speak to most, but in my experience, this has not happened. I've had several ruptures with my therapist. Some of them were harder to get past, and some were handled better on his end than others, but he's stuck it out. But I've also stuck it out. There were times when I wasn't so sure about going back, and I told him that, but I have a lot invested in this relationship and I didn't want to just give up on it. I feel bad for the clients of therapists who run away at the first sign of trouble.

[LonesomeTonight]

I agree on the information being slanted on this forum. I've had a couple major ruptures with my therapist. After one of them, I left for a bit, but that was my choice. He was still willing to continue working with me (and explicitly told me that). I went back a few weeks later after trying a different T. He's said before that he's only once terminated a client, and that was a case when they physically threatened him, and he had to call the police. And that he also feels that working through ruptures makes the relationship stronger.

With ex-marriage counselor, the last major rupture we had, he tightened some boundaries, but did not say I/we had to stop seeing him. I found that, even after trying to work through it, I could no longer fully trust him and ultimately chose to leave.

But in neither of those cases was I forced to leave. I have read about numerous cases on here where a therapist terminated due to a rupture, the client admitting transference, the client crossing a boundary of the therapist's, etc. And those have really concerned and scared me. I really hope that those are the rare exceptions. As I feel a therapist should be willing to try to work through any sort of rupture, transference, etc. short of something like a threat (or actual assault) to themselves or their loved ones. At the very least (again, barring threat of physical danger), they should give the client a few sessions to work through what happened and, ideally, let them keep seeing them until they can find a new therapist. Not just say "OK, you can never come back or communicate with me again."

[CharlieStarDust]

I've also had my share of ruptures in recent years and my T has always wanted and even pushed for us to talk about it and work through it. There have been numerous times when I've professed that she was the issue - and again, she's always encouraged me to express it. I also had a time when I kept feeling distant from her and I stopped seeing her - with no notice. And after a while she reached out. I went back and she said she was struggling with me just disappearing and wasn't sure if reaching out was the right decision - but she went with her gut and with what she thought was best for me.

[ArtleyWilkins]

I also think the information here is probably slanted. Personally, I’ve never had an issue with a therapist rise to the level of a rupture because my therapists were quite open to discussion and dialogue and give and take. We were able to talk through whatever issues might have come up before they reached the point of a rupture. I am personally aware of quite a few other people in my circle who have been through therapy without ruptures, without being terminated, etc. Honestly, the concepts of rupture and termination were not in my realm of understanding at all until I landed here on PC.

[here today]

It may well be that most clients find that therapists do not leave them during a rupture.

But I think it's still a realistic possibility that clients need to consider, because it DOES happen. I never expected it to happen to me -- and then it did. Perhaps considering the possibility is enough for a client to take reasonable precautions inside themself not to trust too much, or something. Especially if there are no other good options. But there still may well be an uncertainty there.

It may well be more likely to happen with some clients than others. Perhaps it's something about the client and/or the kinds of client-therapist dynamics that some of us tend to get into -- transference/countertransference at some very deep levels or something.

But none of that changes fact that it can and does happen, and can be devastating when it does.

[Mountaindewed]

I’m currently going through a rupture with mine. I see her on Tuesday for the first time in 2 weeks and I honestly am not sure what is going to happen. I just know I’ve been doing well these past 2 weeks for the most part, but especially this week I’ve been doing good and I am happy. My family says my therapist is the issue. But I don’t want to leave her. I feel like my situation is similar to a bad relationship almost.

[guy1111]

I try to think of my therapist(s) as a businessman/woman. I try to think of them as surgeons of the mind. Some have fired me, and some I have fired. They provide me a service and I pay them for it. Some are awesome at their job and have brought me great joy and relief, some suck and make things worse.

[nottrustin]

Originally Posted by here today

It may well be that most clients find that therapists do not leave them during a rupture.

But I think it's still a realistic possibility that clients need to consider, because it DOES happen. I never expected it to happen to me -- and then it did. Perhaps considering the possibility is enough for a client to take reasonable precautions inside themself not to trust too much, or something. Especially if there are no other good options. But there still may well be an uncertainty there.

It may well be more likely to happen with some clients than others. Perhaps it's something about the client and/or the kinds of client-therapist dynamics that some of us tend to get into -- transference/countertransference at some very deep levels or something.

But none of that changes fact that it can and does happen, and can be devastating when it does.

I am sure it can happen which is sad.

[Amyjay]

I agree that it is really sad when therapists are not able to practise the virtue of detachment enough to work through the ruptures experienced in the therapy room. Some therapists are just not up to the job.
Out of all the therapists I have seen in my life I think only one was useless.
And I think clients also have to be able to tolerate the stress of working through ruptures too.

[divine1966]

This forum doesn’t represent the entire population. Like if you go on “cheating” forum people who post there usually have cheating spouses, but it doesn’t mean every spouse out there is cheating. It’s just who posts on that forum have that experience.

I know ton of people irl who are seeing a therapist, people in my family, people I deal with professionally, friends etc They only ever have good or at least decent experiences and would have nothing bad to share on here. Many (not all) people who post on here do have bad experiences so that’s why they post on here.

Of course many people I’ve read on here had the most horrid experiences. But they don’t represent the entire population who sees therapists. They represent population who had a bad experience.

[Rive.]

No, most therapists will not leave their clients during a rupture.

Some training programs also 'work on' hanging in with a client who may criticise or complain etc. Not saying it never happens, unfortunately it does - but these are incompetent human beings.

[junkDNA]

If my therapist left me bc of a rupture he'd had left in the first year haha

[JaneTennison1]

If you are a therapist worth anything a rupture will be very interesting. What is the client saying and why? Does it come for another place and if so wh6? Growing up no one ever asked why I behaved the way I did and I think if a therapist misses it then they are probably not a good therapist.

[satsuma]

My T said ‘we always work it out’ and ‘we always learn something’, and that was very important. We had a number of ruptures that were very painful and awful at the time, but T was right because it was a learning experience for both of us - with hindsight - and also I think he wanted me to learn that you can disagree or fall out with someone and still work it out - so part of the template of a healthy relationship. When I look back now I think I was very difficult to work with. If I said that to T he would say something opposite, like he was impressed by my commitment or something like that. Anyway I know I’ve been very fortunate with my T, and with a good T ruptures CAN be a valuable experience overall even though it’s horrible at the time.

[Lunatyc]

Wow. All the doctors, I have spoken to have called me difficult, for getting to the point, knowing when I need med tweaking a tad, for solving my own problems and not demanding much of their time. They should have been saying, my life would be easier if I had more clients like you. Come to think of it, at 18 they did say I was one of the ones worth their time. #### promised myself, no more posting. More work, less time online. More time kick starting my personal Web page/blogger.

[ScarletPimpernel]

I disagree. I don't know if ex-T and I were in a rupture when she terminated me. Maybe? Probably. But she was just one T out of a total of 10. And I've had 8 pdocs all who never terminated with me over a rupture. Though I did terminate one T and one pdoc myself.

I've had a few ruptures with T and L. None have resulted in them wanting/threatening to leave. Quite the opposite. They encouraged me to work through it. And we did and it made us stronger, more resilient.

[here today]

Originally Posted by Amyjay

I agree that it is really sad when therapists are not able to practise the virtue of detachment enough to work through the ruptures experienced in the therapy room. Some therapists are just not up to the job.
Out of all the therapists I have seen in my life I think only one was useless.
And I think clients also have to be able to tolerate the stress of working through ruptures too.

I disagree with what I bolded. That wasn't my situation -- I am one of the ones whose long-term THERAPIST wasn't able to tolerate the stress of working through ruptures.

But still, the result is the same -- expecting more of a client than they come to therapy with.

I don't know how a therapist might address something like that, if they think that's something they are noticing, besides just letting things slide for the client. But isn't that their job? Or needs to be considered part of their job? Currently, it may well NOT be -- and therapists are getting off the hook because too many clients are not well enough to demand something better.

[Amyjay]

Originally Posted by here today

I disagree with what I bolded. That wasn't my situation -- I am one of the ones whose long-term THERAPIST wasn't able to tolerate the stress of working through ruptures.

But still, the result is the same -- expecting more of a client than they come to therapy with.

I don't know how a therapist might address something like that, if they think that's something they are noticing, besides just letting things slide for the client. But isn't that their job? Or needs to be considered part of their job? Currently, it may well NOT be -- and therapists are getting off the hook because too many clients are not well enough to demand something better.

I am not blaming. I am not shaming. I am NOT saying it has to be either the client of the therapist's fault. I am also NOT commenting on your particular situation or insinuating that you were to blame. But, clients do need to be ready to tolerate the stress of rupture if they are able to stick around to see it through, too. The therapist - as the trained professional - obviously has the onus on them to be able to guide, address and resolve a rupture - but the client also needs to have the stress tolerance to be able to stick around to address it. Obviously not all therapists have the skill or ability to be able to do that, and those therapists do cause enormous harm for the clients.
I know that can read as though I think more is expected of clients. But I don't mean that. Clients are at where clients are at, and unfortunately there are times where clients just aren't ready to tolerate that stress, and no amount of support or intention will change that outcome... because the client is just not ready.
There can be a ton of reasons for that. The client doesn't yet have sufficient self-calming skills. The client doesn't have sufficient support in the their daily life. The client is severely dissociative and doesn't have sufficient internal resources. A million other things. And there are several examples of clients not having the internal resources to tolerate the stress of resolving ruptures right here in this forum.
I am not blaming. This isn't about blame. This is just sometimes the reality of the situation... that the client doesn't *yet* have enough internal resources to tolerate the stress of a rupture in the therapeutic relationship.

[here today]

Originally Posted by Amyjay

I am not blaming. I am not shaming. I am NOT saying it has to be either the client of the therapist's fault. I am also NOT commenting on your particular situation or insinuating that you were to blame. But, clients do need to be ready to tolerate the stress of rupture if they are able to stick around to see it through, too. The therapist - as the trained professional - obviously has the onus on them to be able to guide, address and resolve a rupture - but the client also needs to have the stress tolerance to be able to stick around to address it. Obviously not all therapists have the skill or ability to be able to do that, and those therapists do cause enormous harm for the clients.
I know that can read as though I think more is expected of clients. But I don't mean that. Clients are at where clients are at, and unfortunately there are times where clients just aren't ready to tolerate that stress, and no amount of support or intention will change that outcome... because the client is just not ready.
There can be a ton of reasons for that. The client doesn't yet have sufficient self-calming skills. The client doesn't have sufficient support in the their daily life. The client is severely dissociative and doesn't have sufficient internal resources. A million other things. And there are several examples of clients not having the internal resources to tolerate the stress of resolving ruptures right here in this forum.
I am not blaming. This isn't about blame. This is just sometimes the reality of the situation... that the client doesn't *yet* have enough internal resources to tolerate the stress of a rupture in the therapeutic relationship.

Did I say that you were blaming? I don't see that unreasonable expectations on the part of the therapist, or the public, is necessarily blame -- although it could come to that.

I do agree with what you wrote and that I bolded above.