Written by: Angela Derrick, Ph.D. & Susan McClanahan, Ph.D.
Date Posted: March 3, 2025 5:58 am
Rupture and repair in therapy, especially within a relational approach rooted in attachment theory, have much to contribute to the health of our relationships, in dealing with conflict, and in healing from complex trauma (C-PTSD). Romantic partnerships, families, friends, and therapeutic alliances, to name a few, are imperfect human relationships that are never entirely free from conflict. Misunderstandings are inevitable. However, what truly defines the strength of a relationship is not the absence of moments of disconnection but the ability to gently repair them. Maintaining healthy human connection requires the skill to repair after a rupture, and if practiced consistently, it provides opportunities for deeper intimacy, trust, and growth.
Dr. Angela Derrick notes, “Many clients initially don’t feel safe confronting their therapist or providing their therapist with feedback, due to the belief that they will be invalidated or made to feel in the wrong, as has happened in their relationships outside of therapy. They are genuinely surprised and relieved when a therapist encourages feedback and responds positively and openly to their concerns. It makes for some of the best and most healing moments in therapy.”
In this article, we will explore how the cycle of rupture and repair unfolds, its impacts on complex trauma (C-PTSD), the benefits of a relational approach in therapy, and how attachment theory plays a role in healing broken bonds.
Rupture is a break in emotional connection that impacts trust or understanding between two people. Miscommunication, unmet expectations, unresolved trauma, or deeper emotional wounds can cause this. Ruptures can be minor (like forgetting an important date) or major (betrayal or abandonment).
Repair is the process of first acknowledging and addressing what happened–“I noticed you cringed when I asked you a question about your childhood. Can you tell me what just happened so I can understand where you are coming from?” Once understanding is achieved, the disconnection can be healed. This process requires emotional attunement, open communication, and a willingness to reconnect. When dealing with conflict through repair is successful, relationships often emerge stronger. In fact, reconnection after a misunderstanding can offer a deeper emotional intimacy than if the rupture had never occurred.
Perfectionism is often the enemy because it does not allow for authentic or vulnerable connections in relationships. Likewise, people-pleasing and approval-seeking create the same barriers. Therapy can help break down these difficulties and allow for the process of forming deeper connections to ourselves and others.
Let’s explore a couple of example scenarios where we can see rupture and repair play out and how we might greatly benefit from working on these skills, especially with the help of a qualified therapist.
In this scenario, you’ve been working hard on a project, and your boss gives you blunt, dismissive feedback without acknowledging your effort.
Rupture (Boss): “I don’t know why this took you so long. This should have been finished days ago, and honestly, it’s not even what I was looking for. You need to be more efficient next time.”
Response: It’s easy to imagine that you might be feeling the freeze response right about now. After all, shutting down is common when faced with an abrupt or harsh interaction, especially in a power dynamic like this. Let’s say in dealing with the conflict you end up apologizing for not producing the work that was wanted while also emphasizing that quite a lot of effort was put into it, but next time, you will be sure to ask more questions.
Boss: “Well, effort is great, but it doesn’t matter if the outcome isn’t what I asked for. I don’t have time to micromanage, so next time, just get it right the first time.”
Response: You are likely experiencing stronger emotions now. It’s understandable if you’ve shifted from shock to anger or resentment. You might respond with a terse “understood” and withdraw from the situation.
This reaction makes total sense. Stepping away at this point would be an option to protect yourself from further frustration or saying something you might regret, but how do you move on to the process of repair? Since the boss in this scenario does not seem naturally self-aware, the recipient may need to initiate the repair.
At this point, you may still have strong feelings and a sense that your boss isn’t willing to take accountability. Perhaps you want to focus on repairing what you can internally while promising to speak up the next time it happens (and we all know it will!). Concentrating on your own emotional experience and setting boundaries will provide you with the necessary space to reconnect with your empathy and allow the conversation to evolve. You can prepare to respond the moment the next incident arises. Here’s how the repair might unfold:
“I hear and understand your concerns about the project and appreciate your position. I will be sure to ask more clarifying questions next time to ensure I’m aligned with your expectations. It’s important to me to do good work, and I would like to avoid misunderstanding if at all possible. However, I also feel frustrated by how this was communicated. I worked hard on this project, and it’s distressing when my efforts are disregarded. Moving forward, I would appreciate it if we could find a way to have a more constructive conversation about feedback so that I can grow and make necessary improvements.”
This response balances your acknowledgment of your boss’s concerns while also speaking up for yourself authentically and setting a boundary about how you want to be treated in the future. If accepted and reciprocated by your boss, this attempt at repair can strengthen your relationship and likely improve future outcomes. It’s important to note, however, that it always takes two willing parties to be successful when it comes to dealing with conflict through rupture and repair.
Therapy is often seen as a safe space where one can do deep work, but conflict can and does occur even within the therapist-client relationship. In fact, it may even be desirable, as the practice of repair tends to strengthen relationships like nothing else can and leads to improved outcomes. If left unaddressed, however, these ruptures can cause distrust and disengagement.
Conflicts can occur when clients feel misunderstood, invalidated, ambivalent, or emotionally distant from their therapist. When a therapist acknowledges the rupture and is able to facilitate the repair successfully, clients experience a powerful model of healing, learning that conflicts do not necessarily mean the end of a relationship.
For individuals with complex PTSD or attachment wounds, therapy can be a particularly intense and messy space where past relationship traumas are reactivated. For therapists, asking questions, being curious, and taking notice of the nuances that occur in body language, facial expressions, and words are needed skills in order to shine a light on these moments. Questions such as “Where did you just go?” or “What is happening between us right now?” can slow down the process and invite authentic responses and space to explore the misalignment. If the therapist skillfully navigates these ruptures, it provides a corrective emotional experience, teaching clients that relationships can withstand challenges and grow stronger.
Let’s look at our second example scenario where we can see rupture and repair at work in a therapeutic setting:
Let’s say you are discussing a difficult emotional experience with your therapist, and they unintentionally dismiss or minimize your feelings, reminding you of times when your family didn’t listen to or acknowledge your needs.
Rupture (Therapist): “I understand why you might feel upset, but can we try to view this experience from a more balanced perspective? You’ve handled this kind of situation before, right? It seems like you are having a strong reaction that may be disproportionate to the actual incident we’re discussing.”
Response: Your trigger-driven response can be a complex blend of frustration and defensiveness, mixed with conflicting feelings that suggest you might be wrong or at fault–that your feelings are “too big”—or perhaps you feel embarrassed for making a big deal out of nothing.However, you might have enough recovery to realize that believing you are fundamentally flawed or blaming yourself will not lead to true healing. At best, it will only temporarily suppress your feelings, and at worst, it can result in unexpressed grief and depression.
After acknowledging these deeper emotional layers, let’s explore how you might co-create a repair with your therapist. You might say the following:
“I’m feeling really frustrated right now, and I think I need to be honest about it. When you mentioned that I might be making this a bigger deal than it is (at least that’s what I heard you say in my head), I immediately felt like I was in the wrong and should stop feeling upset. I know that’s a pattern for me, and I recognize that you have often pointed out how my triggered emotions can reflect experiences from my past when I often felt unheard or dismissed. I’m frustrated because I know that feeling of being unseen, and I don’t want to fall back into old behaviors like trying to suppress it or be in denial about it.”
If you and your therapist have built trust and safety together over time, it is more likely that you can enter repair mode by expressing your emotional response and showing vulnerability. This action allows you to be seen and understood. Your therapist can then provide greater insight and help you process through your grief. Additionally, you both have an opportunity to correct any misattunement and move forward stronger for the effort. These ruptures and repairs will happen repeatedly, and learning how to deal with them in therapy can help you translate those skills to improve your relationships out in the world.
The relational approach to rupture and repair in therapy emphasizes the importance of the therapist-client relationship as a central vehicle for healing. Unlike traditional models that focus primarily on symptom reduction, the relational approach views therapy as a dynamic, co-created experience where both therapist and client actively engage in the process of building trust, navigating conflict, and deepening emotional awareness. In this model, ruptures—such as misunderstandings, moments of emotional withdrawal, or perceived therapist misalignment —are not seen as failures but as valuable opportunities for growth. By openly addressing these disruptions within the therapeutic relationship, clients learn that conflict does not have to lead to abandonment and that relationships can withstand challenges and still remain strong.
A key element of the relational approach is mutual authenticity and repair. Therapists in this framework do not position themselves as distant, neutral figures but instead, acknowledge their own emotional responses and missteps when necessary. When a rupture occurs, a therapist might say, “I sense that something I said didn’t sit well with you—can we explore that together?” This open acknowledgment models healthy relational repair, helping clients develop the ability to engage in similar processes outside of therapy. Over time, clients internalize these repair experiences, allowing them to build more secure, resilient relationships in their personal lives. The relational approach fosters a deep sense of safety, trust, and relational healing by prioritizing connection over perfection.
Complex PTSD (C-PTSD), though not an official diagnosis (yet), is a widely accepted psychological condition that arises from prolonged exposure to trauma, often in childhood or over an extended period at any age. Unlike traditional PTSD, which is typically linked to a single traumatic event like an assault or a car crash, C-PTSD results from repeated relational trauma, such as emotional neglect, abuse, or abandonment.
Individuals with C-PTSD often struggle with rupture and repair because past experiences have taught them that relationships are unsafe, unpredictable, or emotionally harmful. In dealing with conflict they may respond with extreme distress, avoidance, or a fear-driven need to appease others. When ruptures occur, they may assume that the relationship is permanently broken rather than something that can be mended.
Healing from C-PTSD involves recognizing these patterns and slowly building trust in the possibility of repair. Therapy can help rewire these responses, teaching individuals that relationships can endure difficulties and that conflict does not always mean abandonment. Lily Hope Lucario, “a true lived experience expert in the genre of CPTSD,”has a fantastic list of potential questions she recommends to help discern if a therapist will be suitable for treating C-PTSD. Check out this informative list of questions here.
The SpringSource Book Club recently read and discussed Stephanie Foo’s “What My Bones Know: A Memoir of Healing from Complex Trauma.” She weaves an intense account of her own abuse, the collective trauma of her community, and her journey through a diagnosis of C-PTSD. Stephanie explores various therapeutic and holistic modalities in her pursuit of healing, ultimately finding significant progress through treatment with a perfect (for her) therapist who skillfully employs rupture and repair therapy.
Stephanie has a wonderful video on her Instagram where she discusses this messy and intense healing process with her therapist, Dr. Jacob Ham. Her talent for storytelling is impressive, showcasing her strong research skills, her care for the reader, and her determination to express love and find healing. As a bonus, if you get the audiobook, you will hear her narration alongside actual recordings from her therapy sessions at the end, highlighting the rupture and repair process. It’s fascinating and healing.
Dissociation is a psychological defense mechanism that occurs when an individual feels overwhelmed by intense emotions or traumatic experiences. It often manifests as a sense of detachment from one’s thoughts, feelings, or surroundings—almost as if observing oneself from outside the body. This phenomenon can serve as a temporary escape from pain, allowing individuals to cope with distressing memories or feelings that seem unbearable in the moment. However, when dissociation becomes a frequent or chronic response, it may interfere with emotional processing, making it challenging for individuals to fully engage in relationships or therapeutic work.
In the context of rupture and repair, dissociation can complicate the healing process by creating a barrier to genuine emotional connection. When someone dissociates, they might miss subtle cues of relational rupture or be unable to communicate their inner experience effectively, hindering the possibility of repair. Addressing dissociation in therapy involves developing grounding techniques and fostering an increased awareness of one’s emotional state, which can help individuals reconnect with the present moment. By understanding dissociation as a protective response rather than a personal shortcoming, both clients and therapists can work together to gradually mend ruptured connections, ultimately paving the way for deeper intimacy and a more resilient sense of self.
Attachment theory is a therapeutic or interpersonal strategy that prioritizes understanding and addressing the impact of early childhood attachment experiences on current relationships. Attachment theory views relationships as the primary lens through which to heal and grow, informed by how early bonds with caregivers shaped an individual’s sense of self and trust in others. Securely attached individuals believe that relationships are safe, that others can be trusted, and that conflict can be resolved. However, those with insecure attachment styles—whether anxious, avoidant, or disorganized—may struggle with rupture and repair.
Understanding attachment styles helps individuals and couples navigate rupture and repair with more awareness. For example, an anxiously attached person can learn to tolerate temporary disconnection without panicking, while an avoidantly attached person can work on staying emotionally present rather than shutting down. Returning to an emotionally connected placeis the goal for repairing miscommunications, ruptures, and attachment injuries.
1. Recognizing the Rupture
The first step in the healing cycle is recognizing when a rupture has occurred. This recognition requires the ability to identify distancing and feelings of hurt or resentment. Emotional awareness is also necessary. When in therapy, a rupture may present as resistance, withdrawal, or anger. In romantic relationships, it might manifest as passive-aggression, furious arguments, or giving the silent treatment.
2. Regulating Emotions
Before attempting repair, both parties need to regulate their emotions. Reacting impulsively can deepen the rupture rather than mend it. Practices such as deep breathing, mindfulness, or taking a short break can help individuals calm down before engaging in repair.
3. Taking Responsibility and Communicating
Effective repair requires acknowledging the rupture and taking responsibility. This does not mean one person is entirely to blame; rather, both individuals reflect on their role in the conflict. A simple but powerful way to start a repair conversation is by saying:
“I feel hurt because…” or “I recognize that my words/actions may have hurt you, and I want to understand how we can repair this.”
In therapy, a therapist might acknowledge a rupture by saying, “I sense that something I said may have felt invalidating—can we talk about that?”
4. Expressing Vulnerability
True repair happens when both parties express their deeper emotions rather than just their surface reactions. Instead of responding with defensiveness or anger, sharing vulnerable feelings—such as sadness, fear, or disappointment—creates an opening for understanding.
5. Rebuilding Trust and Reconnection
The final stage of repair involves re-establishing trust and emotional connection. This might be through a heartfelt apology, a shared moment of reassurance, or a new understanding of each other’s needs. The key is consistency—repeated experiences of successful repair build relational security over time.
We have explored how the relational approach to therapy prioritizes building trust, which is key when entering into conflict resolution. Trust and relationship building are also an antidote to cancel culture, a philosophy that causes polarization and includes public shaming, bullying, and implementing stark cut-offs in relationships. We are seeing this mindset show up in therapy, and it is a challenging obstacle to growth, safety, and mental well-being. While detrimental, it can be way too easy to operate in the dehumanizing space of cancel culture (made exponentially worse by social media) rather than work toward being vulnerable, building understanding, and taking accountability. Understanding does not mean agreement; agreement is not the goal. Instead, with love and respect, we can recognize our shared humanity and grow from there.
Rupture is an inevitable part of any close relationship, but repair is what truly strengthens and deepens connections. Whether in therapy or love, learning how to navigate this healing cycle fosters emotional resilience and intimacy. For those with complex PTSD or attachment wounds, this process may take time and patience, but each successful repair experience rewires the brain to believe that relationships can be safe and enduring.
Healing is not about avoiding rupture but learning to trust the repair process. When we embrace this cycle, we transform moments of disconnection into opportunities for deeper connection, growth, and lasting love.
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