How to Repair and Refresh the Therapeutic Relationship

Have you ever really messed up in therapy? Did you say something that you regretted? Did you come off as way too strong or heavy handed?

Or perhaps you didn’t bring “enough” compassion to some very hurt feelings your client was experiencing.

We have all been there. Right? Yes. It’s OK. Really it is.

This post is all about the internal therapist dynamics of what happens when we mis-step. Once we’ve taking responsibility for what has happened, we can then contemplate how to repair and refresh the therapeutic relationship. We can even use this rift and repair to revitalize the work we are doing.

What constitutes “messing up”?

Messing up is obviously a subjective term and one that can be interpreted in myriad of ways.  But let’s list just a few scenarios that illustrate where, how, and when we could “go wrong”.  We can see errors of both omission and commission.

Possible Scenarios

Saying something (perhaps even repeatedly) that is clearly triggering (despite knowing that we need to tread carefully on that particular topic).

 

Ignoring cultural context as we make a sweeping generalization about the client’s life.

 

More forcefully insisting our client take our advice, suggestions, or recommendations (because we “know” this is the best thing.

 

Talking excessively to the point our client tunes us out or even dissociates (if that’s in the cognitive-emotional cards).

 

Directing the session without asking permission. In other words, being one-sided and non-collaborative.

 

Relatively thoughtlessly disclosing personal issues/business so that your client now “feels compelled” to turn her focus to you.

But as just saw, these missteps are rarely all about “you” alone. It’s about what is happening in the room between 2 (or more) people that sparks and illuminates a challenging present, a complex past, or some anticipated future (for each person).

And in the end, all is not lost. We are not horrible therapists or people because of these slip-ups, whether knowingly or unknowingly done.

How to Repair and Refresh the Therapeutic Relationship and Revitalize the Work

  1. The first thing you might want to do is acknowledge what you did and how it felt to you. You might also acknowledge what you think prompted you to act in that way in the first place. Before you go repairing and fixing the relationship, acknowledging and honoring “your stuff” can have a powerful effect. This can help you move through or respectfully release any excess shame, anger, or anxiety we might feel (that might get in your way).
  2. The next step could be to use some Mindsight Skills and ascertain, based on your own feelings and your knowledge of the client’s process, what may have been happening with your client. What prompted you to react to them in this way? What was going on for them that triggered you?  (Even just framing in this way makes it a very relational process vs. one that is happening either to you or to them).
  3. Finally, in the next session, you might express outwardly to your client what you have acknowledged to yourself. Maybe you don’t reveal the whole enchilada, but you might strategically and well, therapeutically, broach the issue with your client.  It might sound something like this:

“Jane, I was thinking about something that happened in here last week. It was bothering me that I think I came off too heavy handed when I told you to do something about how to deal with your boss (or parent, partner, child, etc). I wonder how it felt to you when I gave you such direct and forceful advice?”

From there anything is possible. Your mission is not to erase what happened but rather to own your part in it. You can explore the client’s feelings about what you perceived to be less-than-therapeutic and move forward perhaps with a renewed sense of collaborative spirit.

It is also interesting to notice how your client handles this type of direct communication. We, as human beings, are not often in the habit of directly communicating our sentiments and owning our vulnerabilities when we mess up. So this may be very awkward for some clients.  And perhaps very awkward for you as a therapist as well.

As renowned Acceptance and Commitment Therapy (ACT) founder, Steve Hayes, would say, “Your job is to help your clients FEEL good but not necessarily feel GOOD.” The same goes for us as therapists.

Sometimes the most successful therapy comes out of struggle, challenge, and discomfort.  This might be one of those times.

A Few Final Tips

Seek consultation and peer supervision in general, but also specifically around these kinds of issues of counter-transference, stylistic challenges, interesting behaviors you find yourself performing, and the like.

We usually can’t see ourselves as clearly as others can see us or our situations.

Keep working on compassionate self-awareness. After that, keep working on compassionate self-awareness.  Yes, you read that twice. 🙂

Please drop a comment below  – I’d love to hear about your mess-ups and repairs and how you handled them. (As always, discretion and maintenance of confidentiality are vitally important when posting 🙂 )

Be well and be kind to yourself along the way,

Matt

About the Author

Dr. Matt Hersh is a practicing clinical psychologist, mindfulness meditation teacher, blogger, and socially conscious entrepreneur. He works directly with children, teens, emerging adults, and adults struggling with anxiety and stress. He is also founder of TheThrivingTherapist.org, a website dedicated to mental health professionals' self-care, wellness, and burnout prevention.

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