Psychotherapy: Ruptures and Repairs Between You and Your Therapist

In the current post, I want to look deeper into the profound impact of ruptures in treatment. More importantly, I want to address how these fractures can be intentionally repaired so that the alliance between therapist and client can be preserved, protected, and in many cases, allowed to truly thrive.

What Are Ruptures in Psychotherapy?

In any long-term, depth-oriented psychotherapy, treatment ruptures are bound to occur. Most frequently, these disruptions happen when a clinician unwittingly commits an empathic failure. 

Even the most highly attuned, seasoned psychotherapist will occasionally misunderstand a client’s underlying meaning, misread a somatic cue or offer a verbal intervention that feels misattuned. These moments are almost never intentional; they are simply human errors.

When a client—particularly an individual navigating deep trauma or structural fragility—feels that their therapist has been insensitive, dismissive, or fundamentally incapable of hearing them, the client experiences a sudden thought spiral of disconnection. This internal shift constitutes a treatment rupture.

Ruptures exist on a wide spectrum:

• Micro-Ruptures: These are minor omissions, such as a therapist momentarily forgetting a small detail of a client's historical timeline or family background.
• Macro-Ruptures: These are significant, destabilizing events where the core sense of relational safety is abruptly shaken.

Whether a fracture is experienced as large or small depends on a variety of overlapping clinical factors. These include the baseline strength of the therapeutic alliance, the client’s current emotional resilience, the specific nature of the therapist's misstep, and the client's past relational history.

If the therapeutic alliance is strong and historical ruptures have been rare, clients can often tolerate a therapist's mistake smoothly, especially if they perceive it as an isolated human error. 

However, if the client and clinician have only recently begun working together, or if the client carries a profound personal history of childhood neglect or relational abuse, even a minor empathic failure can trigger a massive emotional fracture.

Note: Egregious clinical violations, such as sexual boundary crossings or other severe ethical breaches, are not relational ruptures. Those are serious legal and ethical violations that destroy treatment entirely, and they fall completely outside the scope of this discussion.

How Can Relational Fractures Be Repaired?

Given that unintentional empathic failures are an inevitable aspect of long-term psychological work, how do we address them so they do not cause a premature termination of treatment?

The most critical step in repairing any clinical rupture is the therapist's willingness to openly acknowledge the mistake. Except for highly defensive or narcissistic clinicians, most well-trained therapists possess the humility to do this. Even if the therapist did not initially view their own response as an error, once they recognize that the client feels misunderstood, judged, or dropped, the therapist must step forward to take responsibility for that experience.

Almost any non-egregious rupture can become a profound vehicle for growth if the clinician models accountability. For many individuals, simply hearing a professional say "I hear you, I see what I did, and I am truly sorry" can enough to stabilize the relationship.

Many clients grew up in environments where parents or primary caregivers never owned up to their mistakes, frequently blaming the child instead. Experiencing a heartfelt, accountable acknowledgement from a therapist can be deeply reparative in and of itself, offering a new blueprint for relational safety.

Even Seasoned Clinicians Commit Unintentional Empathic Failures

I remember early on in my clinical training at a psychoanalytic institute in the mid-1990s, my peers and I were incredibly anxious about making mistakes. As therapists in training, we carried a deep fear that our lack of experience would cause irreversible emotional damage to the clients trusting us with their care.

During a seminar on empathic failure, one of our most admired and respected instructors shared a personal story about a profound rupture he had committed in his own private practice. At the time, most of the trainees held a strong idealizing transference toward this instructor, making us highly surprised that someone of his immense clinical experience and skill could make a glaring error.

Our instructor was well aware of our idealization. He intentionally shared his mistake to prove that even seasoned, expert clinicians make mistakes, wanting to relieve us of the perfectionistic anxiety that can cause a therapist to become rigid, self-conscious, and emotionally unavailable. 

His core message was clear: It is less about preventing every mistake, and entirely about how the therapist handles the mistake and repairs the rupture afterward.

He told us about a time he completely forgot a long-term client's appointment and walked out of his office. The client had been in therapy multiple times per week with him for several years, navigating historical trauma and deep-seated trust issues.

Throughout the treatment, this client frequently pushed to alter the professional frame, expressing a intense desire to cross traditional boundaries and become personal friends. Because doing so would violate the ethical framework and compromise clinical safety, the instructor had spent years gently, tactfully holding a firm therapeutic line.

While most individuals eventually understand that the clinical bond is a caring but strictly professional relationship, individuals with histories of severe abuse often feel profoundly deprived or rejected when a therapist maintains these vital boundaries. Consequently, their sessions had been chronically rocky, filled with tension surrounding these unmet wishes.

On the afternoon of the rupture, the instructor received an emergency call from his young daughter’s school stating she had fallen ill and needed to be picked up immediately. At the time, his professional plate was incredibly full—managing a demanding private practice, teaching at the institute, providing clinical supervision, and serving on multiple committees.

Exhausted, distracted, and consumed by worry for his child, he walked out of his office, completely forgetting the client’s upcoming session. 

He retrieved his daughter, brought her home, and coordinated with her pediatrician. Fortunately, it was simply a common cold, and she quickly fell asleep.

Relieved and finally relaxing after an intense, stressful sequence of events, he sat down in his living room. It was only in that quiet moment of down-regulation that his nervous system suddenly misfired with a jolt of panic: he realized he had left his vulnerable client standing completely alone outside a locked office door.

It took a while for the therapist and the client to repair their relationship. They had several sessions where the client told the therapist that he was very upset about being forgotten. The therapist, in turn, conveyed his most sincere apology and, eventually, they repaired their relationship. 

After the client accepted his therapist's apology, he was able to tell him that neither of his parents had ever apologized for the abuse and neglect he experienced with them. He was deeply touched and grateful that his therapist owned his mistake and made amends. He also felt cared about by his therapist in a way he had never felt before. So, the incident, which was painful at first, advanced their work together.

Cultivating Relational Safety in Psychotherapy

Navigating fractures and miscommunications is a natural aspect of human relationships. If you are caught in a distressing cycle of worry or feel unable to trust others due to past relational wounds, working with an experienced therapist can help you build a new baseline of psychological safety. 

Processing these dynamics within a secure clinical holding environment allows you to free your nervous system from historical patterns so you can experience a truly fulfilling life.

👤 Josephine Ferraro, LCSW - NYC Psychotherapist and Trauma Specialist

I am a licensed New York City psychotherapist and trauma therapist with over 25 years of clinical experience. 

I see individual adults and people in relationships in my psychotherapy private practice located at 412 Avenue of the Americas (6th Avenue), New York, NY 10011 in Greenwich Village, Manhattan. 

I offer a complimentary 15 minute phone call before setting up an initial appointment.

My approach to trauma therapy is experiential and I have advanced skills in:

• Attachment Focused EMDR Therapy
• Somatic Experiencing Therapy
• IFS Parts Work Therapy
• AEDP Psychotherapy
• Clinical Hypnosis (Hypnotherapy)

I am also an Emotionally Focused (EFT) for Couples Therapist and a Certified Sex Therapist.

 In-person sessions are available at my Greenwich Village office and via teletherapy for clients residing throughout New York State (NYS).

Contact Me
To explore integrative therapy, contact me:

🌐 Visit My Website: Josephine Ferraro, LCSW - NYC Psychotherapist

✉️ Email: josephineferraro@iCloud.com

📞 Call: (917) 742-2624 (during standard business hours)

Parallel Losses For the Psychotherapist and the Client

This article was updated as of September 13, 2026.

Loss and grief are painful, inevitable parts of the human experience, and they are among the most common reasons people seek therapy. 

Yet, healing isn't always a one-way street; there are times in psychotherapy when the therapist and the client navigate parallel losses simultaneously. 

This shared vulnerability occurs far more often than most people realize, transforming the therapeutic session into a uniquely shared, deeply human experience. (To explore these themes further, see my articles on the emotional impact of losing parents and the intersubjective nature of therapy at the end of this post.)

Parallel Losses For the Psychotherapist and the Client

This parallel process between the psychotherapist and client often benefits the therapeutic work because, through her empathy, the therapist has more to give to the client because she is going through a similar process.

In order for this process to be healing for the client, the therapist must be trained and skilled at being able to experience the client's suffering while, at the same time, dipping into her own experience briefly without getting lost in her experience.  

The psychotherapist's focus must be mainly on the client and, while their experiences might be similar in some ways, the therapist can't assume that the client's experience is exactly the same as the therapist's experience.

From my own experience as a psychotherapist and from what colleagues have told me about their experiences, it's often the case that a client comes to therapy at the same time that a therapist is having a similar experience.

Depending upon the psychotherapist's theoretical orientation, the therapist probably won't share her loss with the client, especially if it will impinge on their work, because the therapy is focused on the client and not the therapist.

There might be times when it is therapeutic for the therapist to share a similar personal experience with the client, but only if it is in the service of furthering their work together.

Let's take a look at how this parallel process between therapist and client shows up in therapy in the following fictional vignette:

Fictional Vignette: Parallel Losses For the Psychotherapist and the Client

Lois

Lois began therapy because her mother, who had advanced Alzheimer's, was rapidly decompensating both physically and mentally.  

Parallel Losses For the Psychotherapist and the Client

Her mother began showing signs of dementia about 10 years before.

Until recently, the decline had been slow and her mother still knew Lois and Lois' siblings.  But a month prior to Lois starting therapy, her mother was becoming increasingly confused and no longer recognized Lois and other family members.

The doctor at the skilled nursing facility where Lois' mother lived told Lois and her siblings that her mother's condition was worsening, and they discussed the treatment plan, including advanced directives.

Lois and her mother were close, and it was excruciating for Lois to see her mother deteriorate over time.  Prior to the dementia, her mother had been very sharp and active, so it was especially difficult for Lois to watch the mother she knew slowly disappear.

She found support at an Alzheimer's support group, but she found her visits to see her mother increasingly difficult.

Knowing that her mother's life would soon be coming to an end, Lois knew that she would need more than her support group.  She needed the one-on-one support of a psychotherapist.

From the first therapy session, Lois felt understood and cared about by her therapist (see my article: The Creation of the "Holding Environment" in Therapy).

In addition to helping Lois cope with emotional pain of watching her mother decompensate due to Alzheimer's disease, the therapist also provided Lois with practical information. 

Lois felt fortunate that she found a psychotherapist who was so knowledgeable about loss, grief and the practical issues involved with having a family member who has dementia.

Little did Lois know that her psychotherapist also had a mother who was suffering with advanced Alzheimer's disease, and they were both going through a parallel process.

Lois' therapist wondered if it would be therapeutically beneficial for her to disclose to Lois that she was also going through a similar situation.  But she sensed, based on things that Lois told her, that Lois needed something different from her at this point in time--she needed to feel that her therapist was outside the world of Alzheimer's disease, nursing homes and hospitals.

As a result, her therapist decided that there would be no therapeutic benefit to disclosing her personal situation to Lois, so she kept it to herself.  She didn't want to impinge on Lois' experience.

Even though her therapist didn't disclose her personal situation to Lois, Lois felt that her therapist was present with her in a way that she had never felt before with her other therapists--as if her therapist really understood what Lois was going through--and this was healing for Lois.

Two months before Lois' mother died, her therapist called her to let her know that she would have to cancel their next two appointments because she had a loss in her family.  

When they resumed work together, Lois expressed her condolences to her therapist.  She didn't ask if the person who died was close to her therapist because she already felt overwhelmed by her own emotions.  Sensing that Lois didn't want to know, her therapist didn't divulge that her mother had just died from complications of Alzheimer's.

When Lois got the call from the nursing home that her mother died the night before, she was grief stricken.  All along she was grieving for the changes in her mother.  Somehow, she thought that, since she anticipated her mother's death.  She knew she would be upset, but she didn't think she would be so upset.

After their father died a few years earlier, Lois' siblings looked to her for advice because she was the oldest, and now it was no different with their mother's death.  They looked to her for guidance and emotional support, so Lois was glad to have her weekly therapy sessions so she could get her own emotional support from her therapist.

Lois resumed her therapy sessions a week after her mother died, and she was relieved to feel enveloped in the caring and empathetic environment that her therapist created for her (see my articles: Why is Empathy Important in Psychotherapy? and The Psychotherapist's Empathic Attunement to Unconscious Communication in the Therapy Session).  

Parallel Losses For the Psychotherapist and the Client

She could feel her therapist's attunement to her, and there were times in her sessions when she felt she didn't even need to talk.  It was enough to be there and feel her therapist's empathy.  

Aside from her advanced clinical training and experience, her therapist also had her own therapy that she relied on for her support through the grief process.  

Her therapist had many years of experience helping clients to cope with grief.  As she listened to Lois talk about her feelings, she recognized the parallel experiences between them.  She sensed the similarities as well as the differences in their relationships with their mothers and their experiences of grief.

Just as Lois found these therapy sessions to be healing, her therapist also had an internal experience of how healing these sessions were for herself.

Conclusion

It's not unusual for a psychotherapist and client who are working together in therapy to be having a parallel experience--whether it's about loss, happy experiences, personal relationships or any other experiences.

Most of the time, if the psychotherapist is skilled, experienced and can contain her own experiences with appropriate boundaries, the client can benefit from going through this parallel experience with the therapist--whether the client knows about the parallel experience or not.

There are times when even the most skilled psychotherapists must be aware of their own limitations and not take on certain clients because they are aware that they have a particular emotional vulnerability to whatever the client is going through and the therapy wouldn't be beneficial for the client.  Usually these instances are more the exception than the rule.

The therapist usually makes a decision on a case-by-case basis, depending upon the client's needs and the therapist's comfort level with disclosure, whether or not to disclose her own experience.  For instance, in substance abuse treatment, therapists often reveal their own history with substance abuse because this is an accepted practice in substance abuse treatment.

Psychotherapists' disclosure is a topic where there are many different views.  While the therapist is expected to be genuine and no longer expected to be a "blank screen" with her client, the decision to disclose personal information or not must be viewed in light of whether it would be of therapeutic benefit to the client and not solely for the therapist's benefit.

Getting Help in Therapy

Whether or not to start therapy can be a challenging decision (see my articles: Starting Psychotherapy: It's Not Unusual to Feel Anxious or Ambivalent and Psychotherapy and Beginner's Mind).

Finding a licensed mental health professional who is right for you is a process (see my articles: How to Choose a Psychotherapist).

When you and your psychotherapist are a good match, you can benefit from your work together in ways that might exceed your expectations (see my article: The Benefits of Psychotherapy).

The healing process in therapy can lead to emotional breakthroughs and a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, IFS, AEDP, Somatic Experiencing therapist and a Certified Sex Therapist.

who works with individual adults and couples (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

I offer a free 15 minute phone call before setting up an appointment.

I see clients in my office in Greenwich Village, New York City or online.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

See my articles:

Who Are You After Your Parents Die?,  

Grief: The Emotional Impact of Losing Both of Your Parents and Coping With Grief).  

The Psychotherapy Session: A Unique Intersubjective Experience).

The Holding Environment in Therapy: Maintaining a Safe Environment for the Client

In a prior article, I began a discussion about the holding environment in therapy (see my article: The Creation of the Holding Environment in Therapy).  As I mentioned in that article, the idea that the psychotherapist creates a safe therapeutic holding environment for the client was developed by British psychoanalyst, Donald Winnicott (for more on Winnicott, see my article: Books: "Tea With Winnicott" at 87 Chester Square).  In this article, I'm focusing on a particular aspect of the holding environment, which is the therapist's ability to keep the work emotionally manageable for the client.

The Holding Environment in Therapy

As an example, it's often the case that clients come to therapy because they're not feeling good about themselves.  This can be a lifelong problem or a new development for a client.  Either way, the client might focus on the aspects of himself that he is unhappy about and miss the fact that he has many strengths.

A skilled psychotherapist will usually see the client's strengths, even when the client is unaware of these strengths.  

The challenge for the psychotherapist is when to talk to the client about his strengths.

Timing is everything.  If the therapist brings up the client's strengths too early in therapy, the client, who has a particularly negative view of himself, will often minimize or dismiss the idea that he has these strengths (see my article: Overcoming the Internal Critic).

Some clients, who are focused on what they perceive as emotional deficits in themselves, might even think the therapist is being disingenuous when she tries to talk to them about their strengths (see my article: A Strengths-Based Perspective in Psychotherapy).  

In many cases, on an unconscious level, these clients are too afraid to consider the possibility that they have strengths.  Rather being overwhelmed by their fear, they protect themselves emotionally by remaining stuck in their denial.

It's important that the psychotherapist not interpret the client's reluctance as "resistance."  This comes across as judgmental.  It would only make the client feel uncomfortable and it's not helpful to the work.

If the therapist doesn't know how to handle the client's fear,  this could lead to the client leaving therapy prematurely to avoid dealing with uncomfortable feelings (see my article:  When Clients Leave Therapy Prematurely).

So, the skilled psychotherapist, who is aware that it would be premature to talk to the client about his strengths, must keep these observations to herself until the time is right.  This requires the therapist to be emotionally attuned to the client (see my article: The Psychotherapist's Empathic Attunement).

Even with self critical clients who are willing to explore the possibility that they have strengths, they might perceive their strengths on an intellectual level but not on a deeper emotional level.

For these clients, the therapist might broach the topic of the client's strengths, let the client know that she (the therapist) sees these qualities and will hold a space for them until the client can accept this on an emotional level.

This is a way for the therapist to create a safe holding environment for the client because the client knows that the therapist holds onto these observations until the client is ready.

Let's take a look at a fictional vignette that illustrates these points:

John

John had been in and out of therapy for many years.

He usually attended a few sessions with a therapist, and then he aborted therapy because he felt the therapist didn't understand him.

John struggled with depression, including low self esteem, since he was a child.  He grew up in a household where both parents were mostly preoccupied and paid little attention to John, who was an only child.

John's father often criticized him and told John that he would never amount to anything.  His father's critical comments were so frequent that John internalized them and, over time, believed them.  John's mother was depressed and withdrawn, and she was emotionally unavailable to him.

When he was in school, his teachers often told John that he had a lot of potential, but he was not trying.  From John's depressed perspective, he didn't see a reason to try since he believed his father that he wouldn't ever amount to anything.

As an adult, John drifted from one job to another.  Since he never expected to do well, he put little effort into his work, which resulted in disappointment for him.

John also had very low expectations about relationships.  He had a few close friends, but his romantic relationships didn't last beyond a few months.

He would go through long periods when he didn't even try to meet anyone, but then his loneliness caused him to try again with the same low expectations.  It was an ongoing cycle.

By the time John came to therapy again, he felt he was at a low point.  He was already in his mid-30s and he felt he had nothing to look forward to in his life.

The Holding Environment in Therapy

He told his current therapist at the start of therapy that he left his prior therapists because they were unable to see him as he was.  He felt that each of them saw him as they wanted him to be, which frustrated him.

He appreciated that his former therapists were "nice people" and they tried to speak to him about his personal strengths, but he didn't believe what they were saying.  He wasn't sure if they were mistaken or if they were intentionally trying to boost his confidence in a false way.  

Either way, whether the therapist was well-meaning but wrong or whether the therapist was only trying to boost his confidence and didn't really believe he had strengths, John found these discussions intolerable and he would abort therapy.

John's current therapist could see how self critical he was.  She also saw that he had many strengths.  But she also heard John loud and clear that he was unable to even consider that he had strengths, and she knew, based on what he was telling her, that if she tried to broach this with him, he would leave therapy, as he did in the past.  So she waited until he was ready.

Until then, his therapist remained attuned to John's experience and reflected back to him what he told her.  In doing this, she showed John that she understood how he felt about himself, and for the first time in his life, John felt that he was finally seeing a therapist who understood him.

In the meantime, his therapist held onto her perception of the many strengths she saw in John over time.  She waited until she saw a possible opening to explore this with him.

Gradually, as John felt more comfortable with his therapist, he opened up more with her, and she continued to let him know that she understood how he felt by mirroring back to him.

One day, John came to therapy in an agitated state.  He told his therapist that his new supervisor complimented John on a project.

John's first reaction was to get angry because he thought his supervisor was lying to him or he was trying to manipulate John in some way.

But as he thought about it, John said that he knew his supervisor wasn't a manipulative person, so he doubted that this was the reason for his compliment.  He said that maybe his supervisor was just trying to make him feel good--like some of John's prior therapists.  

Whatever the supervisor's intentions, John found it difficult to sit there and listen to his supervisor's compliments.  He said nothing to his supervisor but, for some reason, John realized, it brought up a lot of shame and sadness for him.

During the next several sessions, John continued to talk about this because his supervisor came to him again and told him that he really liked his work.  This continued to baffle John.

Over time, John became more open to exploring this issue and his own sadness and shame.  He was able to connect his negative feelings about himself to his critical father.

During that time, his therapist continued to maintain an open and empathetic stance with John, allowing John to draw his own conclusions (see my article: Why is Empathy Important in Therapy).

She knew that if she intervened prematurely, John would shut down emotionally and he might leave therapy.  She had to wait until he was ready.

Then, one day John came in and told his therapist that his supervisor took him to lunch.  John was surprised that he enjoyed talking to his supervisor over lunch.  He was also surprised to realize that his supervisor liked him and that his praise really was genuine.

As John opened up more emotionally in therapy, he allowed himself to feel his sadness about being a disappointment to his father.  He wished he could have had a father who was more like his supervisor--a kind and generous man.

As he continued to discuss this in therapy, John became aware that his father was a disappointed, bitter man, and his father didn't feel good about himself.

As he looked at his childhood from an adult perspective, he realized that his father was projecting his own negative feelings about himself onto John (see my article: Looking at Your Childhood Trauma From an Adult Perspective).

This led to John questioning whether his father's perceptions about him were accurate, "Maybe I'm not such a loser after all.  What do you think?"

At that point, his therapist realized that John created a small opening for them to be able to discuss the possibility that he wasn't "a loser" and he might have positive qualities.  She also knew that this was a tentative opening that could shut down if she rushed in because John might get overwhelmed, so she had to be cautious.

His therapist said she observed positive qualities in him, and she explored with him whether he would be open to discussing this.  John responded by shifting in his seat and telling her that it felt uncomfortable but, at the same time, there was a part of him that wanted to talk about it.

Gradually, John was able to explore his feelings.  He trusted his therapist enough to know that she wasn't going to lie, hurt him or try to manipulate him.

His therapist relied on John to tell her whether their discussions about his strengths felt too uncomfortable, and he told his therapist when he felt uncomfortable.  In this way, his therapist was able to maintain an emotionally safe environment for John in their sessions.

The Holding Environment in Therapy

Over time, John developed the emotional tolerance to discuss seeing himself in a positive light.  This was new and scary for him at first, but he was starting to feel better about himself.

By being attuned to John, his therapist was able to provide him with feedback about his positive qualities in "manageable doses" for him.  She respected his feedback when he told her that he was beginning to feel overwhelmed, and she would not push him beyond where he could go emotionally.

Working with John in this way, over time, his therapist was able to help John to mourn what he didn't get as a child and to develop more self confidence (see my article: Psychotherapy and Compassionate Self Acceptance).

Conclusion

There are many ways for a psychotherapist to create a therapeutic holding environment for a client.

One way, as I have discussed in this article, is to keep the therapeutic work manageable for the client.

To create a holding environment, the therapist must be emotionally attuned to the client and intuitively sense when the client is ready to explore uncomfortable issues.  She must also ask the client for feedback.

When the client provides a tentative opening, a skilled therapist doesn't rush in.  She helps to facilitate an exploration that is manageable for the client.

In this way, by being attuned and titrating the work, the therapist helps the client to make progress in therapy.  In other words, going slowly in these particular cases, is more effective than trying to get under the client's defenses and overwhelming the client.

From the outside, it might appear that the work is going too slowly, but with regard to the client's internal world the client is developing the internal resources for more in-depth work.  

Not every client has these particular problems, and in many cases the therapist senses that she can make observations early in therapy without jeopardizing the work.  But for clients who aren't ready, premature explorations often lead to premature endings in therapy because the client aborts therapy.

Getting Help in Therapy

Many people, who could be helped in therapy, never come to therapy and struggle on their own without success.

Finding the "right fit" with a particular therapist might be a matter of trial and error as you interview various therapists (see my article: How to Choose a Psychotherapist).  

I usually tell prospective clients to follow their own instincts when choosing a therapist and not to remain with a therapist if their gut feeling is telling them that it's not working out.  However, if you have a long history of aborting therapy prematurely, it might be worth considering that you're avoiding dealing with certain issues in therapy.

Rather than struggling on your own, you could benefit from seeing an experienced therapist who can help you to work through the problems that are keeping you stuck.

By working through problems that are keeping you stuck, you can lead a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, Somatic Experiencing and Sex Therapist who works with individual adults and couples.

I work in an empathetic, attuned and respectful manner with clients to help them to overcome their problems and maximize their potential.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Why It's Important For Psychotherapists NOT to Have "All the Answers" in Therapy

There was a time in the history of psychotherapy when traditional psychotherapists believed they had  "the answers" for their clients (see my article: A Therapist's Beliefs About Psychotherapy Affect How the Therapist Works With You).

Why It's Important For Psychotherapists Not to Have "All the Answers" in Therapy

Back then, it was assumed a client would come in, free associate to whatever was on his or her mind, and when the time was right, the therapist would make an interpretation as to what was going on for the client.

If the client didn't accept the therapist's interpretation, the client would usually be thought of as being "resistant" (see my article: Understanding the Different Aspects of Yourself That Make You Who You Are).

Fortunately, times have changed and most contemporary therapists work in a more collaborative way with clients.  And yet, there are still many clients who come to therapy who expect the therapist to have "all the answers" to their problems.

Not only is it a distortion of what goes on in therapy to think that a therapist is all-knowing, it's also counterproductive.

And, it's likely that any therapist who presents him or herself as knowing all the answers won't be listening to the client or helping the client to develop his or her own ability to develop insight and inner knowledge.

Self exploration and personal discovery is part of the psychotherapeutic process.  And while it's understandable that some clients want "the answer" to their problems from the therapist, it's not realistic or helpful.

Although psychotherapists, who have advanced training in psychoanalytic or psychodynamic therapy, are trained to do in-depth therapy, they are neither mind readers nor fortunate tellers, so they don't have "all the answers" to your problems.

Why It's Important For Psychotherapists Not to Have "All the Answers" in Therapy

Knowledgeable, skilled therapists can facilitate clients' self exploration and help them to develop the psychological skills to overcome problems and lead a healthier life.

If they're trained as trauma therapists, which not all therapists are, they can also help clients to overcome psychological trauma.

But psychotherapists also need to get to know clients over time, and it would be presumptuous and foolhardy for any therapist to assume that she knows from the start what would be best for the client.

If the therapist assumes that she already knows the answers to the client's problems before there is any psychological exploration, this usually means that the therapist isn't taking the time to listen empathically and to get to know the client.

In my professional opinion, as a psychodynamically trained therapist who has gone on to do advanced trauma training, psychotherapy is an intersubjective experience (see my article:The Therapy Session: A Unique Intersubjective Experience).

It takes time for the client and therapist to develop a therapeutic rapport and this doesn't always happen.  Not every therapist is for every client, and most therapists recognize that it's not always a "good fit" with every client.

Most therapists know that each client is unique and, even when it appears that a particular client might have a similar problem to other clients, there's never a one-size-fits-all approach that will work for every client.

Why It's Important For Psychotherapists Not to Have "All the Answers" in Therapy

A skilled therapist also knows that part of creating a therapeutic rapport is creating a "holding environment," as initially explained by British psychoanalyst, Donald Winnicott, where the client feels safe (see my article: The Creation of the Holding Environment in Therapy).

A skilled therapist also knows that she must listen empathically to what the client is saying on both a  conscious and unconscious level in order to begin to understand what's happening with the client (see my articles: Psychotherapy: Therapists Should Listen and Learn From Their Clients and The Therapist's Empathic Attunement to the Client)

By listening empathically, the therapist is actually learning from the client about the client rather than the other way around where the therapist makes premature interpretations as to what's going on.

It's also the therapist's job to help the client to develop the skills to tolerate the ambiguity of what's going on in therapy, especially during the initial stage of therapy when it might not be so clear.

In other words, some clients come in with a specific problem and while the resolution might not be clear, the problem is clearer than when clients come in a state of general malaise and they're not sure what's going on (see my article:  When You Just Don't Feel Right, It's Hard to Put Your Feelings Into Words).

For the client, developing skills to tolerate ambiguity might include self soothing techniques or other forms of coping skills (see my article:  Developing Coping Skills in Therapy).

There are no quick fixes in psychotherapy, even with some of the more advanced forms of trauma therapy, which tend to be shorter than some forms of talk therapy when there is psychological trauma (see my article: Beyond the "Band Aid" Approach to Overcoming Psychological Problems).

If you're new to psychotherapy, it helps to have realistic expectations of your therapist and of the psychotherapy process.

Generally speaking, the more complex the problem, the longer it takes to work it through in therapy, although therapy shouldn't be an interminable process where you feel you're not making any progress.

Rather than giving you the answers, a skilled therapist helps you to get to know yourself, grow psychologically, and learn how to work through your problems.

Why It's Important For Psychotherapists Not to Have "All the Answers" in Therapy

I recommend that you take your time when you're choosing a psychotherapist (see my article:How to Choose a Psychotherapist).

As part of the process of finding a therapist, you might want to see several therapists to determine which one you feel the most comfortable with before you delve into therapy.

And, as I mentioned before, even highly respected, reputable therapists are not always a "good fit" for everyone, so trust your intuition when making a choice.

Getting Help in Therapy
Many people avoid seeking help in therapy because they believe in common myths and distortions about therapy (see my articles: Common Myths About Psychotherapy: Going to Therapy Means You're "Weak" and Common Myths About Psychotherapy: Therapy Takes a Very Long Time).

It's takes time to develop a sense of trust and safety in therapy, especially if you've had early childhood experiences where you were abused or neglected.

Getting Help in Therapy

Psychotherapy can be a  transformative and dynamic process if you approach it with a sense of openness and curiosity about yourself, choose a therapist who is right for you, and approach therapy with realistic expectations (see my articles: Psychotherapy and Beginners Mind, Starting Therapy With a Sense of Curiosity and Openness and Experiential Therapy Can Be a Transformative Experience That Helps to Achieve Emotional Breakthroughs).

About Me:
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, see my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.