Emotion in an alliance rupture and resolution sequence: A theory-building case study

Abstract

Aims: Alliance rupture and resolution processes are occasions for the client to have his or her core interpersonal patterns activated in the here and now of the therapy and to negotiate them with the therapist. So far, no studies have been conducted on emotional processing, from a sequential perspective using distinct emotion categories, in alliance rupture and resolution therapy sessions. This is the objective of this theory-building case study. Method: This client underwent a 34-session long, psychodynamic psychotherapy within the context of an open trial. An alliance rupture-resolution sequence of two subsequent sessions, along with a third control session, was selected from this case and these sessions were rated using the Classification of Affective-Meaning States (CAMS), an observer-rated method to classify distinct emotions, according to current emotion-focused models. Results: The results indicate that the rupture session was associated, above all, with core maladaptive fear, evoked in the actual here and now of the therapeutic relationship, whereas the resolution session was associated with the expression and experience of adaptive hurt as regards biographical issues of the client. Discussion: These results are discussed with regard to the alliance rupture and resolution model and the exploration of integrating client's emotional processing in the model.

Keywords:

• alliance rupture-resolution
• emotional processing
• theory-building case studies

Acknowledgement

This research was supported by the SNSF Grant 3200BO-100706/1.

Additional information

Notes on contributors

Ueli Kramer

Ueli Kramer is a Senior Researcher at the University of Lausanne, Switzerland. Dr Kramer is interested in change processes in psychotherapy, in particular in clients presenting with personality disorders.

Antonio Pascual-Leone

Antonio Pascual-Leone is Associate Professor in clinical psychology at the University of Windsor, Canada. Dr Pascual-Leone is interested in emotional processing in psychotherapy and emotion-focused psychotherapy.

Jean-Nicolas Despland

Jean-Nicolas Despland is full Professor in psychiatry at the University of Lausanne and director of the University Institute of Psychotherapy, Lausanne, Switzerland. Dr Despland is interested in defence mechanisms and research in psychodynamic psychotherapy.

Yves De Roten

Yves de Roten is Head of the psychotherapy research centre at the University of Lausanne, Switzerland. He is interested in alliance formation processes and their articulation with psychodynamic psychotherapy.