The #1 cause of ruptures to the alliance

[@micheller6804]

I just stopped going to therapy a few days ago. I tried to explain to my therapist why it wasn't working, but she seemed married to a certain method of trauma therapy, and it didn't resonate with me. Ironically, when I explained that I was going to leave, that's when she seemed to finally get what I had been saying. I remember saying that it felt like she was engaging with the process rather than with me as a person. It was sad, because she's a good person who truly wanted to help, but just had this blind spot. Your video is so on point!

[@patriciacoughlinphd1852]

Good for you for speaking up! We must be loyal to our patients, not our methods!

[@SevenRavens007]

I feel so privileged, as a new therapist, so have access to the insights of such an experienced practitioner! These videos are really important to me and my professional development at this stage. Thank you!

[@patriciacoughlinphd1852]

Thanks so much for letting me know.

[@belindabezuidenhout8056]

As a patient, or client as we are called in my neck of the woods, what I need from therapy is to know I'm speaking to a real person and not to a method coming from a textbook with a therapist who is stuck behind their own wall and doesn't even know it. I think this is what therapists miss. They forget that we need a connection more than a method. Yes, within professional boundaries of course, but if the therapist is inauthentic, the patient will pick up on the incongruence and that just makes old wounds of ppl hiding and lying to us re-emerge. Please, to all therapists reading this, just be real. Just be a real person

[@patriciacoughlinphd1852]

The research bears out your statement here. Being an authentic presence, engaged and responsive, is of the utmost importance. I make this point over and over again in my books and trainings - it is WHO WE ARE and what we do that matters. Thanks for your comment.

[@B_27]

I had a number of conflicts/ruptures with my last therapist. They all centred around the theme of very rigid boundaries and her putting her own needs before mine. One example is that a few months into treatment, she decided to change our appointment time from early evening to first thing in the morning. As I work full time, early evening was the only time I could go to appointments. The therapist said she was too tired in the afternoons and she was cranky when she got home (a rather lame excuse in my opinion). Despite me telling her this new time did not suit me, she would not budge. When I expressed my frustration about this and the fact that she didn't appear to care about my needs, she said I need to be willing to accept other people's short comings and that this is a normal part of any long term relationship. Her response was essentially "I understand how you feel but I don't care enough to actually change my behaviour". This sort of thing happened a number of times and I was always made to feel as though I was being unreasonable or that I was the problem.

[@patriciacoughlinphd1852]

It can take time to find the right fit. Hope you keep at it and get good referrals.

[@Malin0908]

I’ve had some ruptures with my therapist. She dosnt know, because i cant Get myself to express what bothered me. Today, we talked about how i feel ugly and how that is Linked to me not being good enough. My therapist mentioned makeup (i do not wear it, because i feel uncomfertable with it on my face, and i feel more ugly) she told me Even she used makeup. I interpreted that as to her saying i would look and feel better if i wore makeup. It was ok in The session but when i got home, my toughts started rushing. Do i look extremly ugly without makeup, maybe i do look better with it on? Maybe my therapist feel uncomfertable with looking at me without it. I used to put on alot of makeup, and would be very self concious when i did not wear it. I finally overcome that and want to embrace how i look naturally. Today i just cried when i got home, hating The face i see in The mirror.

[@patriciacoughlinphd1852]

Please speak to your therapist about your true feelings. Remember, she works for you! You will undermine your progress if you keep hiding what is going on with you. Even worse, you seem to be turning your anger toward her back on yourself. Get on your own side!

[@patriciacoughlinphd1852]

@@Malin0908 Wishing she would read between the lines keeps you in a dependent position. It's up to you to speak up and I encourage you to do so.

[@Malin0908]

@@patriciacoughlinphd1852 yes, but maybe i need that someone sees my needs without me expressing them. I’ve never had that in my life, and i just miss having someone see me and say «i feel something is wrong, please tell» that would feel so good to me. Expressing my needs when no one knows i’m hurting feels so wrong for a number of reasons, and i The shame feeling comes and i hate myself Even more. It’s a viscious cycle. The thing is, i also do not believe my therapist really care about me as a client, and it hurts, and makes it more emberassing to express myself.

[@ofraanker7079]

Thank you!

[@LearningForPsychotherapists]

Beautiful!

[@MousyLeigh]

Love your channel!

[@annasokolova6923]

Useful! Thanks!

[@ebbenielsen7]

If you did not use traditional ISTDP with mentioned patient, what did you do instead?

[@patriciacoughlinphd1852]

Yes, I use ISTDP as my framework but am flexible, based on the needs and capacities of each patient. There is no one size fits all.

[@ebbenielsen7]

So what did you do instead with this patient?

[@kwanhofu2968]

you are good

[@KisDraga]

As Is a client, How can I differentiate if i've experienced a rupture or if I'm simply spiraling in my own emotional crisis from something triggering cptsd / [disorganized] attachment trauma.? Ive felt a loss of connection to my therapist this year and have felt utterly gutted w the fear it means our time has come to and end ..not because of her but because of me. I don't know what I'm trying to process or how to talk to her anymore without feeling intense shame and insecurity. I've tried sharing journal entries with her to let her know but nothing seems to have helped. I miss feeling safe with her but also admitredly feel a slight confused resentment as well

[@patriciacoughlinphd1852]

All I can do is encourage you to open up to her - tell her you've been feeling disconnected and anxious. Try to put your finger on what happened to trigger this. Clearly something happened in the last year. Instead of feeling what you feel toward her you have gotten anxious and are in retreat. I hope your therapist can respond to this so that the two of your can back on track.

[@LunaSky381]

Good content:)

[@patriciacoughlinphd1852]

Thanks for the visit