Therapist performance under pressure: Negotiating emotion, difference, and rupture.

One more time with less jargon: An introduction to “Rupture Repair in Practice”

“…In this regard, these markers have been described in the literature as indicating “empathic failures” (when one is lost or confused due to experiencing emotional dissociation or avoidance by another: e.g., Greenberg, 2011), “misattunements or miscoordnations” (when one's affective response reflects misunderstanding of another affective experience: e.g., Tronick, 2007), “interpersonal pulls or transformations” (when one's behavior is shaped by another's behavior: e.g., Kiesler, 1996), “vicious circles” (when the behaviors of two individuals reinforce each other following the behavioral principle of feedback loops: e.g., Wachtel, 2014) or “enactments” (a similar notion that suggests an implicit and collusive interaction of both patient and therapist belief systems and action patterns: e.g., Mitchell, 1993), and “power dynamics” (when one exerts power over another through objectification, which builds on feminist critique and social constructionism: e.g., Benjamin, 1990): We understand these formulations come with conceptual language that is jargonistic, but these terms also offer bridges to other literatures and corresponding communities. We present them here with this in mind and direct the reader to other sources (e.g., Muran & Eubanks, 2020) for clarification.…”

“…It is theoretically and practically safer (i.e., more inclusive) to stay at a more descriptive, mutually influential level of analysis. We have suggested that therapist use their emotional (or internal) experience as a compass to indicate where they are in relation to their patient and have particularly considered such experiences as anxiety, anger, despair, guilt, shame, competitiveness, boredom, and seduction to be meaningful markers (see Muran & Eubanks, 2020).…”

“…Our AFT protocol was very much influenced by the performance science literature that demonstrates the value of reflecting in action, having support from experts, practicing under pressure, and developing mental representations (see Beilock, 2010; Ericsson et al, 1993; Schon, 1984; Vygotsky, 1980). There are a number of strategies derived from AFT that therapists can do on their own for self‐care and ‐development, such as maintaining a mindfulness practice, keeping an emotion journal, studying recorded sessions, reviewing the literature on heuristics and biases, practicing outside of your comfort zone, and establishing a network of colleagues and supervisors for continuous consultation (see Muran & Eubanks, 2020, for more detail).…”

“…Yes, these can include what has been described as microaggressions (Sue, 2010). Although we originally defined these markers exclusively by patient behaviors, we have recently expanded this definition to include therapist behaviors, as both patients and therapists contribute to ruptures via movements away from and against the other (see Muran & Eubanks, 2020).…”

“…Therapists may need to set certain parameters (and these can be idiosyncratic) to be able to effectively participate in a repair process. See Muran and Eubanks (2020), as well as Safran and Muran (2000).…”