The relationship
Psychotherapy is fundamentally an exploration of how we relate to ourselves and to others, and the client, therapist relationship is no different. The relationship that develops between client and therapist exists within contractual boundaries, but it is also about people being present and connected. There are moments of great attunement in which the client feels heard and understood in ways that feel different from other interactions. The quality of this relationship is recognised as a central element in helping clients move towards lasting change, regardless of the practitioner’s approach.
We are talking about interpersonal relationships here, and as in any relationship, there are also moments when things do not go so well. A misunderstanding, a disappointment, a look, something that can’t quite be said or understood, but is felt by one or both parties. These moments can play out in therapy in numerous ways and could ultimately cause the relationship to break down. Such ruptures present not only a challenge to the therapeutic process, but also an opportunity: can they be recognised, reflected upon, and worked through together?
What constitutes a rupture?
Sometimes it is obvious when things don’t go well. There might be an immediate verbal response, a silence, or a shift in body language, making it clear that something isn’t right. The rupture is apparent, but not yet understood. In such situations, it seems appropriate for either party to be curious and to explore what has happened. This brings us back to the relationship between client and therapist and asks: are they both able to address what has happened? Can both parties stay with the discomfort and think about it together? Much as in everyday life, this isn’t always easy or comfortable, but it says a lot about what the relationship can hold.
Ruptures, however, are not always so apparent. I had previously imagined that it was only obvious when something was going on. As in everyday life, the immediacy of a response lets us know that something has happened. We are conscious of the rupture.
A client missing a session can easily be explained by practical reasons, life happens, after all, but a client who can’t attend might also be communicating something about how they feel about the relationship. Such a ‘withdrawal rupture’ might not be easy to notice, as the absences might come with good reason. Issues with payments, scheduling changes, or holidays can all be explained, but they could also, in some way, express changing feelings about the relationship. It might not even be possible to see this as a rupture, but it can challenge the therapeutic relationship in subtle and potentially damaging ways.
How can we think about ruptures?
Psychotherapy is always a reflection of how we live in the world. The impact of a rupture on the therapeutic relationship often mirrors how such ruptures feel in real life. The difference, however, is that in psychotherapy we have the opportunity to explore what has happened. Within the therapeutic relationship, we can model behaviour from which the client can learn and develop new ways of resolving ruptures.
Being able to acknowledge that something is happening in the relationship can be unsettling, but it is the point at which meaningful exploration begins. For either party, being curious and open to examining what is going on may feel as though the relationship is being tested. This might be inevitable, but what it does offer is the possibility to develop the relationship further. The capacity not only to acknowledge a rupture, but also to articulate what it feels like, and when both parties can think and reflect together, allows it to be understood and worked through.
Learning from ruptures
A rupture in the therapeutic relationship is always possible. Such moments can challenge the relationship, but when they are acknowledged, explored, and reflected upon, they can lead to a deepening of the therapeutic connection. The experience of working through ruptures in therapy gives a lived example of how this might translate into the client’s life outside the therapeutic relationship.
To enquire about psychotherapy sessions with David , please contact him here, or to view our full clinical team, please click here.
David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove.
Further reading by David Work –
Beyond the label: rethinking assessment and diagnosis in psychotherapy
Wearable tech: when is there too much data?
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