ABSTRACT
Sometimes individuals begin therapy, but then it is difficult for them to see their way through their course of therapy. They encounter bumps in the road, and the journey becomes anything but smooth sailing. Why did she/he say this to me? Why now? What am I even doing here? What to do? Oh, gee, unreal. These may be some of the inner thoughts of patients and therapists during and/or after a rupture or an impasse in the therapeutic relationship. A deterioration in the therapeutic or working alliance, whether a withdrawal, confrontation, or a mixed rupture, can disrupt the therapy work of patients and therapists (Mylona & Avdi, 2021). Lipner and colleagues (2020, 2023) explain that the frequency of ruptures can vary widely (3%–84%) subject to the methodology utilized to discern these disagreements, suggesting that rupture definitions vary. The book, Navigating Ruptures, Repairs, and Termination Within the Therapeutic Process, suggests that the therapeutic or working alliance ruptures, tensions, or breaches that occur during therapy, although frequently negative, may be more manageable than anticipated. Sometimes they unfold in ways that are difficult to comprehend and at times that are inopportune. When ruptures or tensions happen, therapists can view them as a chance for a change or as a setback, depending on the capacity of the therapist to discern the ruptures and unpack them (Lipner et al., 2023).
