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I have come across this book entitled Resolving Impasses in Therapeutic Relationships by Sue Nathanson Elkind. I purchased it second hand through Amazon.

This book addresses the ruptures, abrupt terminations and impasses that happen in therapy. The author is a PhD therapist who suffered her own abrupt termination and began to see a need for further discussion about what happens in the therapeutic relationship.

What I never knew and think is important for othes to know is that if you are suffering a bad rupture or impasse in your therapy, there are therapists out there will come in and sort of work as a mediator/consultant to help both parties heal the rupture or work through the termination in a humane way. I wish I had sought my OWN consultation during the month of July when things got so out of control with my T. Maybe if we had someone with a cooler head who was objective about our situation came in and worked with us we could have saved this very important relationship and I would not be suffering the fires of hell right now. I would have been spared this pain and, on some level, I know my T is suffering too. Maybe in some different way but he has to be feeling shame and inadequency and guilt. He has to be second guessing himself about what he could have done better. I know he is a good person who was too scared and unknowledgeable and made bad decisions. It's a shame he didn't have the courage to call in an advisor or consultant to work with us to save my three years of hard work.

Anyway, I still have a long way to read in this book as I just started it but it describes a lot of how I feel as "normal" for what happened to me and it does talk about people struggling for years and years with the remnants of a harmful and abrupt termination.

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I am just bumping this up because Sheychen and Liese expressed an interest in the book and because some of you may have missed it.

I think this book is very important to those of us who have been abruptly terminated and for those others out there who feel that their therapy is at an impasse or could rupture at any point due to some unresolvable issues. I still have more to read and may come back later to comment further on it.

DF... I would say it is written for both because it offers the possibility that the client can go out and seek consultation and bring that back to the therapy to help untangle difficult situations. That it is not unheard of for a third party to work with the therapeutic dyad to find resolution to some issues or discover what is causing a stalemate or problem for both parties.. or even to work out a kind and gentle termination if there is no hope to continue.

I will say that it does go into attachment theory, object relations theory and looks at things from a Freudian, Jungian and Kohutian perspective. What I find the most telling is the thorough case studies that she presents as to things that can and will go wrong in the therapeutic relationship. I can see from one particular case a lot of what went wrong between oldT and me.

Hope that helps. You can read some of the book on google books I think. That may give you a better idea.


When I was seeing my T's backup T this summer, he told me it was not unusual for a person involved in an intense psychotherapy to periodically see a 2nd therapist as a way to gain some perspective on and/or resolve impasses in the primary relationship. In fact, he said that it's probably not done enough.

Does the book discuss if the third party helps to analyze conflicts in terms of transference and/or projection? I know that was one of the things I talked about with bakT and it was very helpful.

I'm interested to hear more about the book when you have had a chance to finish it.

I hope things are going OK with the new T.

Russ, I SO wish I knew about this option during the summer when for those six weeks oldT and I were really in a stalemate and nothing was being accomplished except that we were both so emotional and struggling that we could not find our way out of it. It really breaks my heart to know that perhaps having an outside consultant come in to help us may have saved the relationship. It really meant so much to me and I worked SO hard and it was so difficult at times for me and I was finally moving forward in those last months before the impasse and then I just lost everything... my therapist who I was so attached to, my therapy which I worked so hard for, my son's therapist, my son's group therapy and maybe even his summer therapy camp (not sure about that one yet). I lost my home, I lost the dog I loved, the safe place, and the ability to trust. I would have definitely called on someone else to help us if I knew it was allowed and there were people who do this.

Yes, she does speak mostly in terms of transference and how something she calls the primal wounds in each of us can cause the impasse. If client and therapist share the same wounds and the T has not resolved their stuff it does get in the way of their objectivity. Instead of keeping one foot in your world and one foot in theirs they end up enmeshed or in some reenactment of their or your past.

I had to put the book down for awhile because it was getting so hard to keep reading it and seeing in print what happened to me. I may pick it up again at some point.

Things are going pretty well with newT. I had some awful flashbacks last week and then got really scared that he was going to leave me too and I beeped him. He was very responsive and put my mind at ease about things. I think I was starting to feel somewhat closer to him and it scared the heck out of me.... still does. I need to talk to him about this on Tuesday.

Hope you are hanging in there too.


I had no idea that you lost your home. My God, how awful. I'm so sorry for that. I must have missed that detail over the summer when I was away for most of August.

If client and therapist share the same wounds and the T has not resolved their stuff it does get in the way of their objectivity. Instead of keeping one foot in your world and one foot in theirs they end up enmeshed or in some reenactment of their or your past.

This makes a lot of sense. I guess this is why a lot of therapists have their own Ts.

I'm sorry to hear that you're suffering flashbacks. They sound horrible. But I am glad to hear that your current T seems solid and responsive and very experienced with trauma stuff.

I've never had a flashback, so I know nothing about that experience. I hope you don't mind me asking, but does it feel like a part of you is bringing them into consciousness in an effort to heal it (your) self? I hope you are able to purge - or at least defuse that awful material and get free of it.

I am hanging in there. I don't know if this is my root issue or not, but it's becoming clearer that any kind of real emotional closeness or intimacy activates the wretchedness in my head, as if my very existence is in peril.

Oh my gosh... RUSS... I am so SORRY... I did not mean to mislead you about my home. No I still have my house, where I live with my family. I meant I lost my emotional and spiritual home... my T's office where I was safe and accepted... or at least I thought so.

So sorry to confuse you on that. I was not thinking when I wrote that... obviously Frowner

I wish I could have some extra help but my insurance won't let me. I'm floundering on the Transference issue. My T is the sweetest person I ever met and there's no excuse to mistrust her. But I just can't talk about my dependency because my 2 yr. old part inside feels that there will be an execution if T knows, and I will be the traitor that rats on her. I really mean this, not just trying to be silly dramatic. I wish I could think up some way to tell T and get on with this Transference challenge.
Thanks for replying Liese and Draggers. I just realized today why I can't tell T that my Inner Child is dependent on her. It's because I was raised by many different aunts, who always yelled at me, "I'm not your mother!" Almost every day, and it really hurt. When I was 3 or 4, that was like a death sentence. If T starts saying how she can't be my mother (which I know very well, more than anything in the world) I feel I will just die of fear and embarrassment. I just wish she would say it's OK to have a transference with her, but she never has said that and I'm afraid to take the chance! So, that's the predicament, I'm trying to figure out how to talk about it so therapy can move ahead.
Went to therapy today and showed T a picture of a little girl that I feel represents my Inner Child at two. I talked about the girl looking kinda frail and vulnerable, then T talked about how bad it is for adults to hurt a child. T opened the door so wide I couldn't help walking in. I described what I said her in the post about my aunts shouting at me "I'm not your Mother". Hopefully T will understand why I have so much trouble talking about dependency, and help me talk more. I know she was getting very discouraged with me. That photo really helped, even if it wasn't me. It's good we can read each others posts here and learn ways to get around our fears!

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