Ruptures In The Alliance: Whether We Consider Therapy or Friendships Relationships Are So Often About ‘Getting Past IT’

Recent life events have given ’cause for pause’…reflection, and finally, an intersection of belief systems.

What in the world does THAT mean?

Well I’m not totally sure as this is only the beginning, but let me engage in this process toward understanding, with you

As a therapist I am consistently challenged when building the therapeutic relationship (often referred to as the “alliance“) with the knowledge that fortification of such a bond requires ruptures (tension, disagreements) and resolutions as much as it does communion, understanding, and agreement.

In other words, you have to disagree in order to reach agreement…to disagree.

Sound convoluted?

Sure does!

Let me try again…using something I wrote  awhile back regarding this concept from the therapist’s perspective (it’s actually a text book for therapists):

Impasses or ruptures in the therapeutic alliance may be understood as moments of tension or breakdown in communication between patient and therapist (Safran & Muran, 2000). These moments may fluctuate in strength from seemingly trivial tensions, wherein the patient and/or therapist may be only be partially conscious, to significant breakdowns in collaboration and communication that if not resolved may result in premature termination or treatment failure. Alliance ruptures manifest in various ways. Sometimes the existing tension between patient and therapist is obvious and is addressed and resolved quickly. In other cases, a pseudoalliance or alliance based on a false self develops between the patient and therapist. In such cases a complete treatment can occur without the patient being impacted in any real or beneficial manner (Balint, 1958; Winnicott, 1965).

Still a little jargony, but stick with me for a minute because for all intents and purposes I see this therapist/patient relationship as a parallel to EVERY relationship in our lives, wherein we alternately and simultaneously assume the roles as patient or/and therapist. We are protagonist as well as antagonist in our relationships. We are instigators of both ruptures and resolutions…and IF we are lucky we can get to  place where tension and disillusionment in our bonds with others are simply necessary stumbling blocks in the process towards acceptance and understanding.

Wait…Tension, argument, and disillusionment with another is…Okay?!? Is even desirable in our most intimate and valued friendships?

Aren’t we supposed to get along all the time?!?

Quite simply no, because without the acknowledgment, acceptance, and resolution of disagreements we are…to put it plainly: BEING FAKE!

Consider that person in your life, either in the past or present, who was…just…fine, everything in the relationship exuded conscientiousness and agreeableness…yet YOU always had the slightly disconcerting feeling you didn’t REALLY know this vision-of-“blah”? I have, and it is ultimately unnerving because the purpose of relatedness is to do so in a REAL manner and that means it is going to be a bit messy and uncomfortable from time to time…So get ready…because life is a two-way street meaning negotiation, and not necessarily agreement, is necessary, not optional.

So HOW exactly is this disagreeable and yet necessary process instigated?

Well let’s turn back to “the books” for a minute…I feel like it provides me with a little perspective and clarity:

Stuart Pizer (1992) also describes the essence of therapeutic action as constituted by the engagement of two persons in a process of negotiation…that this process is not purely about negotiation toward consensus. At a deeper level, it taps into fundamental dilemmas of human existence, such as negotiation of one’s desires with those of another, the struggle to experience oneself as a subject while at the same time recognizing the subjectivity of the other (Safran, 1993a), and the tension between the need for agency versus the need for relatedness (Safran & Muran, 2000).

There is something very interesting in this excerpt: subject versus object.

I think that all too often we struggle to assert our agency or subjectivity in our relationships, our opinions, desires, thoughts, feelings without recognizing others’ desire to do the same, hence tension arises and arguments ensue…friendships are ended. However, if we acknowledge that essential or existential need in us ALL we can then move from subjective-thought to empathy (the process of relating to an others feelings and experiences) a process that necessarily opens our experience and almost painlessly creates real relatedness.

But WAIT! It’s not really THAT easy because the road to subjective-relatedness is often difficult…full of aggression and even sometimes disappointment:

As Winnicott (1965) pointed out, an important part of the maturational process consists of seeing that the other is not destroyed by one’s aggression, since this establishes the other as having a real, independent existence as a subject, rather than as an object. While this type of disillusionment is a difficult and painful part of the maturational process, it ultimately helps to establish the other as capable of confirming oneself as real (Safran, 1993a; 1999). In this way, the groundwork is laid for relationships in which reciprocal confirmation can take place.

So…we have to allow our treasured loved-ones to “fall from perfection” before we can truly love them (and be loved by them) mindfully, fully, on EQUAL ground.

Here I am specifically reminded of those too-good-to-be-true-friendships: We never fight! We are perfect for one another! Really? Or are you simply afraid of recognizing and then accepting the faults necessary to being human? There seems to be this Western belief that to argue is BAD, that to disagree is detrimental to relatedness…and honestly I think that’s just too simplistic, completely ignoring the beauty of negotiation and the development (and struggle) of mutual understanding…

Coming to accept both self and other are thus mutually dependent processes that can be facilitated by working through ruptures in the therapeutic alliance. For the patient, establishing the therapeutic relationship requires negotiation at both the interpersonal and intrapsychic level, necessitating constant negotiation that balances the patient’s requirements for agency with their needs for relatedness. The therapist, by empathizing with the patient’s experience and reaction to the rupture, demonstrates that potentially divisive feelings (e.g., anger, disappointment) are acceptable and that experiencing nurturance and relatedness are not contingent on disowning part of oneself. He or she demonstrates that relatedness is possible in the very face of separateness and that nurturance is possible even though it can never completely fill that void that is part of the human condition. If the therapist is good enough, thepatient will gradually come to accept the therapist with all of his or her imperfections. The exploration and working through of alliance ruptures thus paradoxically entails an exploration and affirmation of both the separateness and togetherness of self and other (Safran, 1993a).

And THIS LAST PART is so nice…because it allows for individuality…for difference…for mistakes…for humanity. Too often, I believe the fatal mistake in friendships, therapies, and relationships of any kind is that…we fail to accept the boundaries of the other, separate from our own needs and desires, meaning that realizing that no one in our lives is going to meet all of our expectations AND that is okay! And that the unrealistic need to be connected on EVERY level, that someONE is meant to fulfill all of our yearnings, is not possible or probable, and that ultimately the rough and often undelinated road to connectedness is ALL THAT WE CAN HOPE FOR…

AND YOU KNOW WHAT…THAT IS MORE THAN ENOUGH FOR ME.

You, as you are…with me…separate from me…You are enough…I accept you and understand that we will not ALWAYS agree, nor should we…but we WILL strive to see one an others’ position…and negotiate…TOGETHER…towards LOVE.

Because THAT is what life is all about…from the beginning to the end…love is the greatest alliance of ALL.

Thank you…to my friends, my patients, my lovers…for accepting as I endeavor to do the same…with LOVE, c.

*All excerpts from, The Art and Science of Psychotherapy (2006)

3 thoughts on “Ruptures In The Alliance: Whether We Consider Therapy or Friendships Relationships Are So Often About ‘Getting Past IT’

  1. teo says:

    So true, but still sometimes it’s difficult for me to accept “that no one in our lives is going to meet all of our expectations AND that is okay!” Partly because people really have that “Western belief that to argue is BAD” and if I’m having an argument (and kind of enjoying it), some people would look like “Should I call the police? Are they really about to start a (physical) fight?”…

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