Your therapist and the importance of rapport

Why is rapport with your therapist so important? 

In simple terms, rapport is having an emotional connection with someone. In therapy having a connection with your therapist is crucial and should not be underestimated. In fact, studies indicate that rapport is probably the most significant factor in how successful your therapy is and it’s even more relevant than the experience of the practitioner, training or the type of approach used. Research even suggests that strong rapport can actually result in shorter admissions in psychiatric in-patient care. 

Choosing the right therapist could, therefore, determine the success of your therapy more than you realise. This can especially be the case if you had parents who didn’t or couldn’t meet your emotional needs when you were a child. 

What exactly is rapport in therapy? 

Rapport can be difficult to quantify and may mean different things to different people. Below are some of the things I think are essential. 

One of the key components of the therapeutic relationship is trust and it is vital that you trust your therapist so that you can often reveal your most vulnerable parts of yourself. Only by being vulnerable, can you move towards the place you want to get to and overcome your issue(s). But to have trust you need to feel safe and your therapist should ensure that this is part and parcel of their support. This includes things such as adhering to professional ethics and maintaining your privacy – stuff that they should have been trained to do. 

But it goes deeper than this; it also means being psychologically ‘held’ by your practitioner whilst experiencing strong emotions or relaying difficult times in your life. Being guided and supported each step of the way by someone who only has your best interests in mind and knowing that there are no ‘rights or wrongs’ about what you say during sessions are definitely part of this. 

I would also say that having empathy is another important element of rapport. Understanding that another human being is struggling and responding with warmth sounds basic but it’s so crucial in your recovery. Your therapist should not have to have personal experience of whatever it is that you’re going through but they should know what it’s like to have a hard time, to know that we’re all doing the best with the tools we have at the time. To be human is to struggle. 

It’s a lack of judgement as well – just knowing that you can say whatever you like can be really healing as it allows us to become more personally honest and to have a better relationship with ourselves. 

An equal partnership may mean better therapy 

It is my belief that therapy is more successful and rapport stronger when the client feels that they have some power in the alliance, that the therapist is not some sort of god figure with all the answers. After all, you know yourself better than anyone else ever will. One of the best things about therapy is also learning more about yourself and how you tick. 

As a client, you are an equal partner who has a responsibility to put in the work to make change in whichever direction you wish to go. Your therapist is only a guide and fellow sufferer, another human being who is walking beside you during this process. If you work together to come up with answers, you’ll get much more out of therapy. This means doing stuff outside of sessions that helps you along the way, as change requires effort and is not simply about your practitioner waving a magic wand to make your issues disappear. 

Being equal partners also means that you should ask questions if there’s anything you don’t understand or challenge something you disagree with. Remember, your therapist is not going to get things right all the time. I also think that being honest about when something has not worked for you is going to be beneficial as it means you can both come up with other solutions that are more suitable. Don’t just go along with things for the sake of it – you’ll get so much more out of the process by being an active participant. 

Why attachment theory might explain the significance of rapport

Our need as social creatures to be connected to others can partly explain why a positive relationship with your therapist is so essential. Our very survival depends on trusting those around us (we are pretty helpless when we are young) and having a therapist who you trust means you may be able to learn to trust others in the process if this ability has been previously damaged. 

The attachment theory proposed by psychologist Bowlby stresses the importance of a close, secure bond for babies and their parents. If you did not experience this, or indeed, had distant, critical or even abusive parent(s), you may have developed issues with forming close bonds with others. Bowlby understood that these early relationships acted as a blueprint for later ones and subsequent research supports this. 

If our early relationships were lacking it can lead to us believing that we are unloved or unlovable. This belief may continue into adulthood and taint every relationship we have. If we don’t think we are worthy of love, how can we have healthy relationships with others? I see this so often at the core of my clients' issues. 

Attachment styles – which one describes you?

The type of parenting we receive, according to Bowlby, can impact on our subsequent relationships with others. There are four types of attachment styles.

1. Secure attachment: this is when your emotional needs have been met by your parents. It leads to being able to trust others and have loving relationships. Research also shows that people with this style are better able to cope with stress. 

2. Anxious/Pre-occupied attachment: this can lead to anxiety and a feeling that you are ‘less than’ – especially when compared to others who are ‘better’ than you. You may be clingy in relationships which may have the effect of driving people away. 

3. Avoidant/Dismissive attachment: you may avoid intimacy and find it hard to express your feelings in relationships. You may come across as ‘cold’ or ‘too’ independent and tell yourself you’ve no need for intimate relationships. 

4. Disorganised/Fearful and avoidant: you may distance yourself from close relationships but at the same time feel anxiety around not being loved or cared for. It can feel quite confusing for both you and those around you, as you push them away one minute and then pull them towards you the next.

Rapport: Starting to heal

Having a genuine rapport with your therapist can be a step towards forming a healthy attachment with someone. From this, you can then use it as a model to build attachments with others in your personal life. 

The therapist acts as the surrogate ‘parent’ in the sense that they help you to build up your self-worth, something perhaps you never had as a child. This is when you actually start to heal. Having a strong core and sense of yourself is a crucial foundation for dealing with what life throws at you and the real success of therapy is when you are able to start the walk alone, without the guiding hand of your therapist around your shoulders. 

How to choose the right therapist 

The client and therapist alliance then is a very special relationship. And you owe it to yourself when making the decision to have therapy, to choose a therapist with whom you have a rapport. Don’t just plump for the nearest one to where you live or one that has free parking available. 

Most practitioners offer free consultations and I’d recommend that you take advantage of these to see whether you are a good ‘fit’ for each other. Whilst trust takes time to develop, you should be able to get a feel for how they work and whether they have any empathy with your situation.  

If you are already in therapy and feel that your rapport is lacking, don’t panic. It could be because you’re unconsciously acting out how to behave in relationships during your therapy sessions. For example, if you find yourself becoming angry with your therapist, it could be because they remind you of someone from your life, for example, your mother with whom you have a difficult relationship. Or it could be due to the fact that they are asking you to confront difficult emotions or experiences. 

But trust yourself if you think that your relationship is not working out or the therapist is not right for you. It could be the most important thing you ever do, so spend some time researching until you find the right one.