What we’ve said about Rupture and repair

“the word rupture sounds like a big dramatic clash between two people but we use it more broadly to include even very subtle signs of not being quite on the same page not being completely comfortable with each other”

“patient and therapist, do they agree on the goals of what they're trying to work towards? Then there's tasks. So any kind of treatment involves tasks”

“the other broad category of rupture is confrontation. So withdrawal moving away, confrontation moving against”

“it's inevitable that at points those needs are going to clash or collide or conflict with each other. So in that sense, some kind of rupture is inevitable”

“rupture repair predicts good outcome. So it's really that unrepaired ruptures lead to poor outcome. Repaired ruptures have been so associated with good outcome”

“you're going to make mistakes, right? That's human. And... They present these really amazing opportunities to learn more, better understand, and actually become closer and have a better working relationship on the other side of it”

“When there is a fracture, a rupture in a relationship, they have not been taught to, they are not accustomed to repairing that together with the other person, which this is an example of why the psychotherapy is so important in treatment”

“the easiest way to tell if you are in a good therapy or not is how your therapist responds to you bringing up issues about being in the therapy itself”

“paying attention to the subtle micro moves that we can see or also our own internal reactions. Right. Like your sense, something's a little off or I'm a little uncomfortable or I'm a little bored or whatever. That's an opportunity to be curious”

“you could be talking a lot, but you're still withdrawing. So I'm not really answering your question and I'm going really abstract and over here and over there”

“how intense it is or how long it lasts. will sort of be the distinction between a minor withdrawal that you're like, oh, did I just see something? Maybe I'm not sure”

“she was slightly getting more and more irritated by my questions because I think it was that they were triggering. And when I finally got to something that was really, really upsetting for her and because I wasn't doing a great job monitoring. She got really emotional, she got angry at me”

“the technique is to notice when you or the patient are stepping out of the frame or to notice when there are ruptures in the alliance and how you would repair that”

“we talk about this in terms of metacommunication. That's the fancy word for, like, let's talk about what's happening. Let's communicate about how we're communicating”

“when something comes up like live, in the session i mean that's gold right we want to mine that it's happening right now it's like this amazing opportunity to explore something live to explore something while you're feeling the feelings and thinking the thoughts”

“both ruptures and repairs, we say they're co-constructed, like both people are part of creating it. So that's also for therapists, we can't say do these five things because that leaves out the patient”

“it could be also taking responsibility for our own contributions to it, right? Oh, no wonder you're confused. I wasn't clear. Or I was pushing you. I was rushing you because I was worried about this or that”

“You seem irritable today. What do you suppose is going on? The way we're interacting now seems to be kind of bringing up a lot of irritability. We're not really on the same page. What do you suppose is going on? Probably much more effective”

“I notice that as we're doing this, it seems like I'm irritating you and I don't blame you for that. These are annoying questions. I'm sure you've been asked about them a lot and might not seem clear right away why I'm asking so much or in this way”

“Let's think about it more as, you know, they're going to happen. They can be small. They present opportunities. And I think that attitude helps us approach them with openness, non-defensiveness, curiosity”

“they think of ruptures as like these very explosive things. And especially for therapists, withdrawal and receding your own needs is a huge blind spot”

“this wasn't a time to make a connection to the past or, you know, like intellectualize and think of all the way that connections in this person's life. This is a time to be there and sit there with that emotion”

“So far, research comparing online therapy and in-person therapy are finding little to no difference”