How Do I Manage Ruptures in Relationships with my Service Users?

In psychology and psychotherapy, a “rupture” refers to a breach in a previously well-balanced relationship. Although conflict in relationships with the people we are trying to support can be challenging, it’s also completely normal and often a great point to think together about what is happening in your relationship. In this blog we’ll offer some tips for things it might be helpful to explore when you experience these ruptures with service users. 

The nature of relationships

Firstly, it’s important to understand that all relationships are two-sided. Even if your boundaries are tight, you cannot avoid bringing your own “stuff” into relationships. This might include thoughts about how the work should be going, your previous experience of relationships, how good you feel you are at your job, how well you slept last night, and many other things. The same is true for your service user. They will bring their previous experience of services, relationships, thoughts, feelings, deeply held beliefs, and physical state to your relationship. Whilst much of our work might try to focus on what’s in the room on that day, these other factors will be influencing it. 

This doesn’t make you bad at your job, or bad at boundaries, it makes you human. 

Avoiding blame

Unfortunately, people experiencing homelessness or multiple exclusion will very likely have experienced services blaming them for ruptures in the past. In services we might hear people referred to as “treatment resistant”, “hard to reach”, or “a non-engager”. These labels place all of the blame for relational difficulties on the service user – a person who has likely experienced significant relational trauma previously, as we described in our previous blog. 

Blame is actually not that helpful in these situations. If you blame the service-user for the rupture, you risk re-enacting previous rejecting patterns and pushing them further away. If you blame yourself, you undermine your confidence in your work and might end up punishing or berating yourself for being a human, with all the associated thoughts and feelings which come with being a human being. 

Allow space for feelings

This means your feelings and the feelings of your service user. If something has happened in the relationship and your service user is angry, they are entitled to feel that way. You can ask what they need in that moment – would it be helpful to take a break? Or maybe even leave the session there for the day? Noticing and naming feelings together can be helpful, for example “I’m wondering if something that’s happening is making you feel angry? I noticed that you’ve moved in your chair and you’re looking away from me, which is different to how we started today. What would be helpful to do now?”. Of course, if someone is becoming physically or verbally aggressive, you might have to remove the choice from this situation and let them know that you will have to end the session there, but that they can come back and talk more at a later time. 

Your emotions are also important feedback in these situations. How did the conversation make you feel? When did you notice that something had gone differently to how you might have hoped or expected? How did you notice? What feelings are you left with after the session? Reflective practice can be a great place to think about these feelings and any thoughts which are coming up in a non-judgemental and supportive environment. 

Open up the conversation

A much more helpful way of dealing with a rupture is conversation. As we’ve seen above, this doesn’t have to be in the moment if it’s not appropriate. Reaching out with a text message to let the service user know that their feelings were valid, but that you’d like to talk about what happened when you next meet can be a nice way to avoid dismissing their feelings but also letting them know that you want to explore it further. It can demonstrate that you want to understand and work together on your relationship. 

Gently noticing changes in body language can be a great way to start a conversation about ruptures. For example, “I noticed you pulled a bit of a face when I used the word compassion just now, and I was wondering whether we could talk a bit about what was going through your mind when I used that word?”. This could open up a conversation about what compassion means to that person. For example, we might use that word thinking of kindness and support for ourselves and others, but our service user could hear a word loaded with victimhood or being a burden. We can’t always second guess what experiences our service users have had previously, and how this might have left them feeling about certain things. We can’t always avoid triggers and difficult topics. We can talk about them though, and if we come from a place of genuine curiosity and wanting to understand, we can build better relationships out of ruptures. 

If this blog has been a helpful start to think about ruptures when working with service users, please do contact us to talk to us about other support we can provide for you and your team.