When I was being trained, myself and my fellow psychotherapy trainees lived in fear of committing that which at a time prior to the development of relational theory was labeled a “therapeutic error.” There was unfortunately a long list of such errors, most of which were not grievable offenses, but could nevertheless get you blamed for the untimely ending of a treatment and garner the disapproval of colleagues and supervisors.
One type of those previously unforgivable errors was the therapist outbursts. They were characterized as spontaneous emotional utterances that arose straight out of the unconscious of the therapist without benefit of thought or reflection. Therefore, they were assumed to be inappropriate at the least and destructive to the therapy at worst.
Fortunately, as relational theory became more sophisticated in its applications, many scholars in our field began to write about the power of therapist outbursts to create shifts in the direction of a treatment that proved to be extremely transformative. They are now seen as a type of right brain to right brain communication that makes therapeutic use of the therapist’s ability, freedom and willingness to share an unplanned personal impression from their own unconscious in service of capturing a healing moment. Infrequently therapist outbursts do destroy a therapeutic alliance, but working through all the emotions involved for the clients and the therapist is often quite constructive.
At the tender age of 26, I was in marital treatment to attempt to save my first marriage. I was relaying an incident to our therapist in which I had invited the woman I knew my former husband was having an affair with–and her husband–to dinner at our home. With a look of utter disbelief on his face, the therapist forcefully blurted out, “Don’t ever do that again!” This was a guy who had never raised his voice or said anything critical during the treatment. To this day, this is the only statement he made during the treatment that I remember with complete clarity. The little girl inside me who had been taught to be “nice” above all felt understood and cared for in a way I never had before.
I had been treating a couple who were referred to me after a domestic violence incident. After 2 years of working with them to understand the threat to the safety of their relationship inherent in blaming, the wife stated once again in a session that their problems were all her husband’s fault. Likely resulting from my frustration at her seeming refusal to stop acting unsafe, I made a statement that I never make in marital treatment — “Well, I guess I’ve done everything I can for the two of you.” It clearly felt to me like an outburst. The wife looked stunned and panicked, but something shifted. The couple separated for two weeks and then came back to therapy with a renewed sense of both feeling safe in my office.
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