Getting on the same page: Introducing alliance rupture as a path to mutual empathy and change in psychotherapy

Patient and therapist interpersonal interactions and the negotiation of negative process, often referred to as rupture resolution, have been shown to be critical to the change process in psychotherapy. In this chapter, we will present an evidence-based stage process model of rupture resolution, demonstrating a progression from mutual recognition of a rupture by patient and therapist, towards a greater mutual expression of patient and therapist perceptions of the rupture, and subsequently, mutual empathy, where greater understanding of patient and therapist subjectivities is achieved. A clinical illustration will be included throughout to illustrate this movement towards mutual empathy.