There are times in therapy when it just isn’t working. If you’re sitting on the couch, body language stiff as an ironing board, tight-lipped, teeth-gritted, glaring at each other with matching po-faced death-stares and thinking that the person who breaks eye contact or speaks first loses; then the therapeutic alliance vehicle has crashed into a tree. It is not pleasant, but it happens, and sometimes it can happen in good therapy.

For whatever reason the therapist just isn’t getting it, whatever “it” is. That resonant, spiraling, attuned, limbic dance of healing connection has faltered and a brick wall has been erected in the therapeutic play-space. This is highly unlikely to be broken down in the very near future, there’s twenty minutes left and all you can hear is the quiet, constant, irritating tick of the clock.

This is when it’s important to remember that the connection you shared in a previous session can be restored. It’s not a completely lost cause. Although if you can do that single-handedly without the therapist’s help, the chances are you don’t need therapy in the first place or the therapy you have received has kicked in and you can muster up the courage to face the fear behind the conflict with some potent tools the very same therapist has armed you with.

There can be so much heavy, intense, emotional investment from the client in the relationship that any discord can feel like a permanent, non-repairable rupture and for some that can feel like you’ve just lost your best friend. You can either work it through together with lots of “I” statements, flick imaginary elastic bands in their general direction – or change therapists. If you’ve had a previous good rapport, my advice from experience is to stick with it and work it through. When you’ve been therapist shopping most of your adult life, it could be a repetitive way of relating that comes from you and if that is the case, then all therapists will feel like an epic fail.

Painful as it is, bridging that gap is most important and strangely enough, can lead to greater harmony and a deeper connection. Chances are you came into therapy because your real-life relationships were simply not working, so by recovering your equipoise with your therapist, you can transpose this learning experience onto outside relationships. Only be careful with this because most people have not had therapy, are not therapists and will not act according to the therapeutic script you have written exclusively for them.

Making up is more important than what caused the break-up in the first place. An excellent therapist knows this and will encourage positive open dialogue with both parties contributing equally. Mistakes and ruptures with your good-enough therapist is a marvelous opportunity to practice redress of any potentially devastating situation.

It’s not always animosity that can cause therapy to come to a grinding halt. In all relationships, including and sometimes especially in therapy, the process can get stuck in a rut. Therapy stagnates and all avenues of exploration just hit a dead end. This is what Freud calls resistance and supposedly comes from the client. The theory behind this idea is that your issues are so problematic and traumatic to reveal they are suppressed (actively repressed) or repressed (an unconscious process totally out of cognitive awareness). In other words, it is simply too unbearably painful to even think about let alone bring them out into the open. It is the therapist’s job to recognize this and work out alternative strategies to bypass the blockage and get the whole therapy process back on track.

Therapists are human. Human beings make mistakes. But in therapy, in a differential power relationship where you are paying huge amounts of money on a weekly basis for a corrective experience or in the words of Carl Rogers, unconditional positive regard, a good therapist will apologise, make amends and start the repair process themselves whether they feel they are at fault or not. After all, in the transference process, where we unconsciously displace a negative or positive emotion from one person to another, the therapist is the “parent” and the client is the “child” and thus the therapist has far greater power to wield.

So the therapist needs to act like the caring, mature parent. That can open the pathway to discussing the estrangement. If those awkward, sick-making feelings and differences of opinion are not recognised, rectified and validated by the therapist, the client does have the option of voting with their feet.

Dissonant therapy can set the client back, weeks, months or even years. Especially when the client has a tendency to regress under stressful conditions. Of course under these circumstances engagement in any sort of authentic communication is out of the question. They tend to people-please their therapists even though the sub-text going on in their head is that this is a complete waste of money, time and effort.

When I talk about alienation or disunity, I’m not talking about regressed client hissy-fits, overweened expectations or angry temper tantrums where the client threatens violence, and the therapist pretty much has the right to instantly terminate the business transaction. Rather it is where there is dissonance about the type of therapy and how it is being administered and how validated one feels, as well as the level of connection or disconnection and whether or not the client is feeling healed by the therapist’s ministrations.

Then there is retraumatization, where the therapist is insisting they have the correct version of events and validate the people who originally traumatized the client. This is the sign of a really bad therapist. This can have a “Stockholm Syndrome” effect on the client, where you are so attached to therapy or the therapist in a negative transference and it’s just not working, but you feel powerless to leave. People who have dependent personalities and live with abusive partners are especially vulnerable to this type of transference.

So when you’re in therapy and you start crying for your mother or father, there’s a pretty reasonable chance therapy is a retraumatization process.

And who wants to pay for that.

 


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    Last reviewed: 27 Jul 2009

APA Reference
Neale, S. (2009). My Therapist Doesn't Understand Me. Psych Central. Retrieved on October 2, 2014, from http://blogs.psychcentral.com/unplugged/2009/07/my-therapist-doesnt-understand-me/

 

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