Dealing with Disappointed Clients and Ruptures in the Relationship

By Eckhard Roediger, MD, author of Contextual Schema Therapy

Sometimes clients will express to you that they are disappointed with their therapy, or the lack of outcomes with their therapy. Disappointed clients are a challenge in therapy, since they activate our own patterns (or schemas). Many therapists try to avoid a rupture by finding a quick “solution” to maintain the working alliance. Literally “stepping out” of the interaction instead, and taking a deeper look at the underlying needs, can strengthen the therapy relationship much more.

In moments like these, why not try shifting your perspective by moving around a bit? Here’s a technique for looking behind their feeling of disappointment together. Try standing up together side by side and “floating above the chairs” in a joint perspective. Then, work with the client to investigate what has been going on down there while you were seated in the chairs. The effect is amazing!

You can deepen the effect of the physical perspective change by changing into third-person language, too. This exercise helps cool down the client’s triggered emotions and reestablish the working alliance between you and your client as an “observer team”—you are, after all, observing the emotional experience together.

Instead of going too deeply into the content of your past conversations, I suggest asking the client questions that focus on the underlying needs, interpersonal intentions, and the resulting pattern. For example:

•          What did the client feel?

•          What needs did he or she feel at that time?

•          How did he or she express this need?

•          What was the desired outcome?

•          What was the actual outcome?

•          Does this happen to the client more often?

Then, ask the client if they have a good and competent friend. Invite the client to step into this friend’s shoes by asking: “Thank you, [friend’s name], for coming to help us. You know [client’s name] well. What do you think about the situation and what [client’s name] really needs now?” Once the client managed to distance from their emotional activation and you repaired the working alliance on the observer level, they can access their innate resources again and show up with promising ideas.

An example: Many clients hide their vulnerable side behind a wall of anger—but there are often more vulnerable emotions behind anger that you and your client can examine together. Stepping out of the anger activation and getting in touch with the underlying vulnerable side again allows expressing the need for support. This encourages others to help instead of withdrawing. Looking down on the scene from above and stepping into the best friend’s shoes helps access the hidden feelings and express them. This enables clients to communicate more effectively.

Eckhard Roediger, MD, is director of the Frankfurt Schema Therapy Institute, the first established in Germany. He is former president of the International Society of Schema Therapy (ISST), and board member since its foundation in 2008. He has been a schema therapy trainer and supervisor since 2008, and is author of numerous books, book chapters, and articles about schema therapy in German.