For those who have had ruptures with their Ts.

Would you avoid bringing something up in case it caused a rupture between you when things had previously been going ok and you didn't want to risk that? Or if you felt it was serious enough to disrail the relationship, take the chance and broach it with them?


[trigger] For context: last session my T left it too late in the hour to address something I'd mentioned (re sui thoughts) in an email, it felt like she wasn't present with me and how I was feeling, it felt a bit dismissed. She has previously said she was only a text, email or phone call away if I was feeling like I wanted to act on my thoughts; but last session said if I had contacted her by phone over the weekend it "would have crossed a boundary" and that we should "deal with it in an extra session."

So now I'm confused as to whether it's ok to contact her when feeling like that or not.

Is this something you would bring up for discussion? [trigger/]

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In an ideal world, I think it’s always best to bring this up, otherwise it can fester and harm the relationship. At least this is the advice I’d give a friend. In reality, I struggle to say anything to him that sounds like criticism as I’m afraid he’ll get annoyed/defensive and stop seeing me. That’s obviously more to do with my anxieties than with how he is, but it’s hard. Would it be easier if you emailed your T in advance with your concerns so that you don’t have to do it face to face?

I used to be very concerned about bringing things up, though I always did because people on this forum recommend to do so.

By now, we have worked through multiple ruptures. My T has not only reassured me that none of my worries would happen just because we have an argument, but he has also every time pointed out how he thinks the most fruitful discussions happen during ruptures. I tend to agree with him. I especially thinks it helps to repeatedly fear that something bad might happen, but it actually turns out to be completely fine. I think I'm more calm when something upsets me about T and I start to trust that everything's still going to be fine.

I can understand how you're upset about what happened during your session. I'd certainly bring it up, already just because I couldn't deal with not being sure what's okay and what's not. My T and I have very clear boundaries around outside contact and I think well-known boundaries are important for both the client and the therapist. I couldn't stand the uncertainty of not knowing which ways of contact are okay and would get a response and so on. Also, maybe your T didn't remember what she said or wasn't aware how important that thing in the email was and she can only know if you bring it up, which might help in the future.

L and I have been through a lot of ruptures. I have always brought them up. I believe if they don't know, how can they help you?

Like CNS said, this is about boundaries and it's important to understand them clearly. Not knowing will only lead to more pains and hurts. This is important to bring up to her.

I think in this situation it sounds like you’re asking for clarification, rather than bringing something up that might cause an issue. I’ve been in that boat, and I straight up said you’ve said X and you’ve said y. Which is it, because you’re sending mixed messages and I’m confused. I’m lucky that I have a strong therapeutic alliance with my T, and she’s pretty good at owning her stuff when it affects me (and is true). If you’re not sure about the relationship, this might be a good way to challenge yourself to advocate for yourself and see if she’s worth it.

I also understand why you're upset and would be as well. I've been through my share of ruptures with my T. I agree that it's important to bring up something that's bothering you, or else it's going to continue to be there and negatively affect the relationship.

However, I've come to learn that how you bring up an issue with a T can be important (well, for my T, anyway, as he can be a bit sensitive). In this case, you could focus on how you were confused by what she said and want to clarify. To say something like, "From what you said before, a call would be OK. But then you said last session that calling would be crossing a boundary. So I'm confused. Did I misunderstand before? Is a call still OK? What should I do if I'm having those feelings? Does it depend on whether it's the weekend vs. a weekday? Is a text OK but not a call? I just want to make sure I understand and don't cross a boundary."

Basically focusing on wanting to understand and being on the same page. Rather than something like, "You told me before that I could call and now you're saying I can't? What's going on? You're being dismissive." Not that you would say it that way. But I know that times when I'm upset and feeling hurt, things I've said to my T (or to other people in my life) can come out wrong, like I'm attacking them. Which can then lead to the other person getting defensive. These sorts of understandings in tone have generally happened for me when I've emailed as opposed to talking in person (or in a virtual session).

Note that some T's may get defensive any time they feel at all challenged or questioned by a client. Though that's a fault in the T. Not the client. But I do think in general it can help to present it more as "I want to make sure that we're on the same page."

I do think it can also be good to bring up when you feel your T isn't fully present with you, though mine has said it's best to do so in the moment, rather than after the fact, as in the moment, he could adjust (or explain, like if there was something that were distracting him unrelated to me). Hope this is helpful in some way and that you'll be able to have a productive discussion with your T about this (without it leading to a rupture).

This is a good point LT and has made me reflect on how I bring up things to my T. I bring up ALOT of things that happen in the room but thinking about it now it likely sounds very critical. She sometimes gets defensive ...or even if not it sometimes changes the mood of the session.. I'm going to try this approach and see if it helps

I think the approach suggested by @LonesomeTonight is a good one. And you do need clarification. Maybe there are times of day when it is ok to call her, but other times when you should call a crisis line instead. I understand if she's saying she can't be on call 24/7. But she needs to explain that to you.

Have resurrected this thread because once again I'm in potential rupture-territory.

So after challenging my T last year about all the interruptions in our therapy hour, things did indeed improve. She was on time. There were no interruptions from her phone / doorbell / cat.... Sessions went back to how they should be, and our therapy relationship eventually returned to normal after this brief rupture.

However, recently sessions have been going downhill again. Several times she's texted me asking if we can start the session a bit later than expected. The phone / doorbell /cat, interruptions are starting to creep in again.

Although we managed to work through it before, she took my criticism of how the disruption was impacting my sessions rather badly; and for that reason, I am reluctant to mention that it's becoming a problem again, to her.

The rational part of me is saying that I should be able to say something about this, because I am paying for her time to focus on what I'm in therapy for... The emotional part of me however, hates conflict and doesn't feel able to raise it with her a second time. But I am starting to resent forking out money each week for sub-par service.

I have 3 choices: I can put up with it and say nothing. I can say something and risk another rupture. Or I can leave.
None of these are particularly appealing, but I know I have to make a decision.

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It sounds awful to have so many interruptions and uncertainty. And it is so frustrating that things improved for awhile but have fallen back now. Phone interruptions should never happen. That is totally within her control. I have never had a session interrupted by a phone call. While you can't prevent the doorbell from ringing every time, it definitely seems like something could be done. Sessions not starting on time is also something under her control.

I think it is worth bringing it up to her but I think you have to know that while it may improve in the short term, it is likely to happen again. If that does happen then I think you have to make a decision.

What are you asking is totally reasonable. An occasional, extremely rare interruption is one thing. Life does get in the way sometimes, but this is more than this and how can it not affect the work you are doing?

I am sorry this is happening.

I'm sorry you're dealing with this again. And I tend to be conflict-averse, so I get it. But I think it's worth bringing up to see if it changes rather than leaving or just putting up with it. If she responds poorly to your mention of it, then I'd consider leaving.

Maybe it would help to focus on the disruptions that affect you the most or the ones most under her control? Like is it starting late? If it's starting late, that could be a time-management issue from the session(s) before yours, so she should be able to manage that. Also, does she make up the time at the end of session? If not, that's not really fair to you. If so, that could still be a problem because it's taking up your time.

The phone or doorbell? (Though she may not be able to help the doorbell being rung--I suppose if it's a delivery she's expecting, she could try to place a note outside saying not to ring the bell. The phone, she could put on silent or turn off (if it's a landline, she should still be able to turn off the ringer, or else get a new phone where she can turn the ringer off. And the cat--she should be able to just shut the door, and if the cat tries to come in, oh well (or shut it in another room during session.

Maybe try to put the focus on how it's affecting you. Like, "When I'm in the middle of talking about trauma (or whatever topic), hearing the doorbell or hearing your phone ring is very jarring." Or how it makes you lose your train of thought. Or "When you start late, even though you give me extra time, it affects my work schedule" (or whatever schedule it affects, even if it's just that you have to waste time waiting for her to be ready for session to start that you could be using for something else). Or even just that you prefer the frame of starting on time, which is completely reasonable.

That could help rather than framing it more as what she's doing wrong. I hope it goes well and she's receptive if you do talk about it.