Weird rupture in alliance in personal counseling

[HarperF]

Hi SDN,

Originally I posted this to the Psych Central Psychotherapy forums, but the mods suggested posting it here instead.

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.

As the client, 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 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 for development.

I appreciate your thoughts.

---

Members don't see this ad.

 

[dcpsychdoc]

Hi SDN,

Originally I posted this to the Psych Central Psychotherapy forums, but the mods suggested posting it here instead.

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.

As the client, 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 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 for development.

I appreciate your thoughts.

This sounds like a complex situation. Where is this therapy occurring, in the US? I am also curious about your therapist’s credentials.

 

[HarperF]

This is happening in Europe, Hungary. Therapist has a PsyD level clinical psychologist degree.

 

[summerbabe]

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.

If I thought that I was no longer providing intervention-based care for a patient, that would be grounds for beginning the termination process. I work in a time-limited setting so I don't have experience with 100+ hour self-pay clients but as you identified, the therapist stated that it feels more like (paid) friendship than professional help seeking.

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 for development.

I'm only going off what you shared but this perspective doesn't strike me as healthy. A therapist can provide comfort and can help motivate us to grow/change to be better versions of ourselves in our normal environments. But when therapy itself takes on an outsized role and becomes a central place where this change is perceived to be happening, that doesn't seem ideal and could potentially be harmful for patients IMO.

I've had patients that I genuinely liked as people but I have zero desire to have any relationship outside of the therapeutic setting (and I wouldn't expect any patients to want that from me either). Sometimes I find myself wondering what previous patients may be up to or how they are doing but I let that thought pass because that's a boundary I've established for myself.

There were a couple of boundary crossings though, so I can understand where T is coming from regarding not having completely sanitized sessions.

That's not ideal. And a lot of times, we don't know when we cross a boundary because we don't know the subjective reactions of others. But it's also possible your therapist feels like they have or could potentially cross a boundary that feels unethical or otherwise professionally unacceptable.

My advice would be terminate this relationship and if you continue to seek counseling, do some heavy self-reflection of what you want from therapy. Was it primarily to work on your own goals or to work with that therapist on these goals? If it's the former, I'm sure you can find somebody else who can help you.

 

[HarperF]

Thank you Summerbabe for your extensive reply!

If I thought that I was no longer providing intervention-based care for a patient, that would be grounds for beginning the termination process. I work in a time-limited setting so I don't have experience with 100+ hour self-pay clients but as you identified, the therapist stated that it feels more like (paid) friendship than professional help seeking.

Yes, we weren't on intervention-based grounds for a long time. We've had goals and T was working with nonspecific variables.

I'm only going off what you shared but this perspective doesn't strike me as healthy. A therapist can provide comfort and can help motivate us to grow/change to be better versions of ourselves in our normal environments. But when therapy itself takes on an outsized role and becomes a central place where this change is perceived to be happening, that doesn't seem ideal and could potentially be harmful for patients IMO.

I think I didn't phrase this the correct way. I do change in all of my environments. I don't see it taking on an outsized role, though it's certainly pretty stimulating due to my training to be a therapist as well.

I've had patients that I genuinely liked as people but I have zero desire to have any relationship outside of the therapeutic setting (and I wouldn't expect any patients to want that from me either). Sometimes I find myself wondering what previous patients may be up to or how they are doing but I let that thought pass because that's a boundary I've established for myself.

I think this is the boundary T has estabilished as well.

That's not ideal. And a lot of times, we don't know when we cross a boundary because we don't know the subjective reactions of others. But it's also possible your therapist feels like they have or could potentially cross a boundary that feels unethical or otherwise professionally unacceptable.

Usually it was T to cross boundaries like that. This is an unavoidable dual relationship, as we're in a small rural city, and both of us are psychologists. I think we have about 5-10 people both of us know personally.

My advice would be terminate this relationship and if you continue to seek counseling, do some heavy self-reflection of what you want from therapy. Was it primarily to work on your own goals or to work with that therapist on these goals? If it's the former, I'm sure you can find somebody else who can help you.

The goal was negotiated between us. If I wouldn't have known T, it wouldn't have crossed my mind to pick this goal. It wasn't the interventions, it's the relationship that was the greatest help for me - by far.

 

[AcronymAllergy]

Mod Note: While I can appreciate the relationship of the topic of therapeutic alliance to the larger forum, as this thread specifically discusses personal therapy experiences that are unrelated to training (and SDN is not for seeking medical/mental health advice), it is being closed.