How many of us have been in the middle of a session with a client when, all of the sudden, the air in the room changes and we realize that things have taken an unexpected turn? Perhaps we’ve tried to guide the conversation in a direction that the client did not want to go or maybe that uncomfortable counter-transference has crept into the room. Our palms are sweaty, the blood is rushing to our faces, and we can feel our voice start to shake a bit. Regardless of what prompted it, the reality is that a rift occurred within the therapeutic relationship, and now you’re feeling the ‘yuck’. What do we do when this inevitable phenomenon happens?

Whew, just in writing that I can feel my anxiety increasing as I don’t know that there are many things more uncomfortable that can occur during a session; I’m confident, though, that I’m not the only therapist that has experienced this. For me, it’s helpful to ground myself first and foremost – I grab my little fidget spinner, take a quick look out the window, or do a few strokes on my beard to get myself back into the room. The first few times that I experienced this, I would immediately think that I had done or said something that caused the flow of the conversation to change. Perhaps I did; maybe I did push things in the wrong direction or it’s possible that I had verbally or non-verbally responded to the client’s last statement that was perceived as invalidating. I’ve learned, though, that making the situation about me plays in opposition to the point of each and every session. Therapy sessions are not about me, they’re about the client and the relationship that forms between myself and the client. Part of my job as a clinician is to model healthy relationships and healthy communication. With this in mind, the rift that occurred didn’t involve just me; it involved the both of us.

Now comes the hard part – bringing this ‘yuck’ out into the open. Of course, every situation is different so, naturally, every response will be different. Regardless of this context of the situation, I always try to remain authentic and honest. I may say something along the lines of, “well that flopped”, “something shifted; did you notice that too?”, “I think I need a minute to get my thoughts together”, or “I think we’re both having some feelings about this right now, would it be okay if we talk about that?” If I had done something that caused the rift, I’ll own it, and if the shift occurred on the client’s side, I’ll provide them with an opportunity to talk about it. I’ve learned that there is no rule book for navigating through these situations. Experience seems to be the only thing that fosters more comfort in sitting with the uncomfortable. I can’t help but think back to my grad school days and hear my first field instructor saying, “We’ve got to find comfort in sitting with the discomfort.”

If any of you have been following my previous blogs, you’ve likely picked up on the fact that authentic and genuine communication is one of my core values and key pillars in therapy. In bringing this ‘rift’ out into the open and providing a safe space to discuss this relational break, I try to model effective communication to the client. Not only is it helpful for the two of us to find a resolve to the situation, my hope is that the client will be able to utilize and take that experience outside of my office walls and apply it to personal relationships. There’s also tremendous value in utilizing the uncomfortable situation in a positive manner for the both of us. The modeling of conflict resolution is tremendously important for a client: by demonstrating my ability to appropriately and effectively talk through the ‘yuck,’ I am able to teach my client healthy ways of resolving relational rifts.

Breakdowns within relationships are a normal and expected thing to happen; therapeutic relationships are not immune to this. We, as therapists, have the ability and obligation to use these uncomfortable experiences as teachable moments. Moments to show our clients that we care enough about them that we will hold their discomfort while we talk through and resolve the uncomfortable, yet expected, ‘yuck.’