Professor Chris Muran has some welcome news for any therapist who fears the idea of a rupture in their relationship with a client: ruptures, and their subsequent repair, can actually produce a better outcome. “It can lead to really intimate moments of knowing another person,” he says. “It has this great change potential.”

This is just as well, because these ruptures (periods of tension between client and therapist) are inescapable. Muran explains: “I expect rupture to always be happening. Ruptures are inevitable between therapist and patient, no matter what kind of therapy is being undertaken, just like they are within any human relationship. Research has demonstrated this.”

We sat down with Professor Chris Muran (who is Dean and Professor at Adelphi University’s Gordon F. Derner School of Psychology, New York) to find out about his nearly four decades of research into the therapeutic alliance, and what therapists need to do to form a strong collaborative bond with clients.

Ruptures in therapy

The therapeutic alliance is “one of the most robust predictors of treatment success and increasingly [researchers] are showing a causal relationship to change,” says Muran, explaining that the power of ruptures in effecting change rests on the premises that:

1. Ruptures represent difficulties in negotiating differences between two individuals, each comprised of many identities, experiences, or selves.

2. The recognition of one’s own unique subjectivity – that our experiences and perspectives can be quite idiosyncratic – results from recognition of another’s unique subjectivity.

3. Ruptures, therefore, “present the possibility of such an intimate encounter and the potential of expanding self-awareness in relation to another, suggesting the possibility of change for both patient and therapist.”

Withdrawal and confrontation

How do therapists recognize when a rupture is happening? Muran advises that therapists look out for two types of behaviors: withdrawal behaviors and confrontation behaviors. Many ruptures contain features of both types.

"Withdrawal is any movement away, either from the other – through isolating actions like going silent – or from the self, such as distancing yourself from your emotional experience. For instance, you might feel anger but not be comfortable with it, so you turn away from it. Any movement away can impact the therapist or the ‘other’ since therapists do this too. It might lead to empathic failure, for example – a misattunement where you don’t fully understand what’s happening in the relationship.”

Confrontation behaviors are movements against the other. “These are criticisms, attacks, or coercions of the other, ranging from blatant hostility to subtler forms. For instance, if a relationship feels overly friendly or becomes sexualized, that’s a type of coercion. It’s distinct from direct complaints like ‘you’re a terrible therapist’ or ‘I’m not doing well here.’ It’s a different experience, but you sense it as a movement against you, and it feels off.

“The other markers that we particularly concentrate on are emotional markers, or what we call intrapersonal markers. This is important because we want therapists to be much more mindful of their intrapersonal experience as a compass of what’s going on. So, if you’re feeling anxious in the room, that could indicate that there’s something going on. If you’re feeling defensive, frustrated, or even bored, there are all sorts of experiences that will speak to something that’s happening in the room.

“We’ve done a lot of work with therapists [including cognitive behavioral therapists] in our alliance-focused training (AFT) to not only recognize behavioral markers, but also be more self-reflective.”

Mindfulness is also an important component, and AFT uses role plays, two-chair work, and empty-chair work to help with this. Muran and his long-term collaborator, the late Jeremy Safran, are believed to be the first people to have introduced mindfulness for therapists into their work, as opposed to just for patients. “It was in the 90s and people thought we were kind of New Age-y and weird. Now everyone’s doing mindfulness, so now we’re not so cool,” he jokes.

Opening up

"There are different challenges that come [when training] an audience that’s cognitive-behavioral versus an audience that’s psychoanalytic," observes Muran. "One of the things we talk about is the value of self-disclosure and how powerful that can be. But we know self-disclosure is tricky. The cognitive-behaviorists, and I’m talking in generalities, can be more action-orientated and gung-ho about it: if they think it’s a technique, they might more readily use it. You might want to train these students to become more not only aware of their experience, but also more judicious about the use of it. Conversely, many analytic students tend to see the patient as a fragile child, so they can be disinclined to self-disclose. These students are more afraid: they’re ‘all in’ with their internal experience. Getting them be more open about that experience with the patient is often the challenge.”

Muran clarifies what therapists should disclose to their clients: “We advocate for affective self-disclosure. That isn’t necessarily anecdotal self-disclosure, like ‘I remember when I was a kid.’ Instead, we encourage judiciously talking from an inter-subjective perspective about when you’re feeling anxious, or defensive, or what could be meaningful about what’s going on in the relationship right now.”

Ultimately, how much a therapist should disclose depends on many factors. “In the relational world, there’s a lot of controversy about self-disclosure. Some people feel that you shouldn’t self-disclose unless you really understand what that disclosure is about; they want to process it before it gets put out there. That’s one end of the spectrum.

“The other end of the spectrum is more dialogic. It feels like there’s no way you can process it in any meaningful way unless it’s shared with the patient, and you process it together. It becomes something that’s co-constructed. At this end of the spectrum, you need the other to really establish a greater sense of what’s going on. At some point you’ll have to take a risk and say something like, ‘I’m going to share this and then we’re going to try and figure this out together’. If you approach things with the attitude that ‘I’m sharing something, I have no idea what it means, and I have no pretense of being the ultimate arbiter of reality’, it’s likely to be received, processed, and played with by the other. But it’s a tough question because there can be too much. There can be too little. And there are probably a million ‘just right’s."

Creating space

What if the patient decides to leave? Muran advises therapists to focus on “being respectful and curious right away. See if you can create a space to talk about it, to understand them, but not with the intention to keep them. If they don’t stay, so be it, but at the very least you might walk away with a better understanding of what went on. You’ll grow from it and maybe they’ll grow from it as well. On the other hand, if you can create a space where you can talk about ways you’ve failed or didn’t meet the client’s needs, they might stay. I remember a wonderful five-minute clip of a therapist’s junior working with a patient. The patient is telling the therapist there’s no way she can ever understand her because she has been in AA [Alcoholics Anonymous] for her whole life and is struggling with addiction, correctly assuming that the therapist didn’t have a history of addiction. What’s really amazing about that clip is that the therapist, although uncomfortable and off-balance, remained open to understanding. One thing that arose – besides her decency – was her curiosity. We used to play that tape as part of an interview process and would ask the interviewee, what they thought happened. Many people assumed the patient left, but they actually completed the whole treatment program.

“So, my answer is to stay open to understanding, and not necessarily to keeping them in treatment. Just stay in the present. I’ve worked with patients who’ve left, only to come back two years later. Having this attitude that you’re potentially a therapist for life is useful. They could come back, they could change their mind, and I don’t think you can ascertain that very quickly.”

Enter the darkness

Muran’s own challenging moments with clients (on top of running a busy psychology school, conducting research and teaching, he still sees clients most days) have usually been when a patient was particularly hopeless or despairing: “The therapist’s impulse is to encourage the client to ‘cheer up’ in subtle ways. I remember doing this. We’re champions of hope, and have our own intolerance for despair. But the consequence of that is that it ends up polarizing things: it ends up making the patient feel isolated and particularly alone in their despair.

“The challenge for therapists is to meet them in that space. That’s difficult because it’s not how we’re trained and it’s not a comfortable space to enter. We need to not try to make things better, but to trust that, by being there, things can get better. There’s an expression that’s centuries old: ‘meet a person in their place of despair where you can kindle hope.’ That’s tough. It’s easy to say this, but to help a trainee or yourself to do this – to enter the darkness – is hard.”

Muran is no stranger to self-criticism or self-doubt. “I think a lot of professionals bring that to the profession. It’s important to help them understand the interpersonal implications of self-doubt, that it's a reflection of something that happened in the [therapeutic] relationship. I don’t think that’s a rationalization; I think it’s very true. These things have gained personal meaning for me, but it’s a challenge for training therapists. How do they understand their self-doubt and use it effectively?”

Early influences

Muran’s career has been multi-faceted. He explains that he’s always had “two sides to me – humanities and science – which I’ll attribute to my heritage in some sense. I come from an Armenian background and Armenians are inherently practical!” His father and grandfather were “practical businessmen”, but his grandmother (his “academic muse” who emigrated to study in Leipzig and Paris before settling in New York) “opened up the world of literature, poetry, philosophy and history” to him.

“I’ve always navigated the world of ideas and the world of practice, so I was doomed to be a psychologist – because a psychologist is a compromise formation,” he jokes. “If I’d gone for philosophy or been a writer I would have given in to one side at the expense of the other. As a psychologist, I’ve been able to satisfy the side of me that wanted to write [as well as practice].”

Starting as a cognitive-behaviorist, he completed his postdoctoral training at the Clarke Institute of Psychiatry in Toronto before studying psychoanalysis in New York.

An alliance for everyone

In the 90s, Muran “caught the wave” of interest in the therapeutic alliance that had developed following the work of psychotherapy researcher and psychodynamic thinker Ed Bordin. “Bordin shifted the alliance from the traditional psychoanalytic notion of the patient adopting the analyst’s view of reality – complying with the therapist’s agenda – to one that instead emphasized the collaborative aspects of the relationship. He looked at how patients and therapists agreed on how they were going to work together, the tasks and the goals, and their emotional bond – to what extent there was mutual respect and trust. It meant there was a more equal playing field, with therapist and client working together, rather than the client just following.”

The alliance became transtheoretical: its ability to fit any kind of therapist-patient relationship triggered interest from cognitive-behaviorists like Muran, and his life-long colleague Jeremy Safran, who had just started to advance the notion of rupture when Muran became his post-doc fellow. Muran remembers: “I became his primary collaborator from the late 80s until his passing [Sadly, Safran was murdered by an intruder at his Brooklyn home in 2022.]. We were writing within the cognitive-behavioral world and really trying to challenge the boundaries there.”

Deeper understanding

By the early 1990s, it became clear to Muran that he needed to go beyond his original (cognitive-behavioral) training, so he began his psychoanalytical education at New York University: “It was not so much that I wanted to be an analyst, but I needed to understand that literature because it was more extensive and richer with regards to looking at the therapeutic relationship.”

New York was, at the time, the “home of the relational movement, which was attempting to integrate ideas mostly within psychoanalysis”, he explains. “An important mentor of Muran’s was Lew Aron, a protégé of Stephen Mitchell, who authored the seminal 1988 work, Relational Concepts in Psychoanalysis: An Integration. I was immersed in that world, being exposed to intersubjective thinking, which has its roots in existential philosophy and feminism, and it became a very important thread within the relational movement. This became integral to how Jeremy and I thought about the therapeutic relationship and rupture.”

Muran remains a cognitive-behaviorist as well. Most of his research has focused on how the therapeutic alliance can improve CBT: “A lot of our grants were written to improve CBT; that’s essentially how we got our funding. By doing so, we were introducing ideas from both the analytic and the humanistic world to complement cognitive behavioral therapy and make it more effective. The [CBT clinical trials] largely show response rates of 60-70%, which means 30-40% of patients don’t respond. There’s also the premature termination literature, which can range from 20-50%. The literature really speaks to a more sober view of the effect of psychotherapy. Our thinking was: ‘how can we make psychotherapy better?', and, 'let’s focus on the change process, and particularly on this alliance construct which is getting a lot of attention and empirical support’.”

Muran has since published more than 180 papers as well as 10 books; his latest book, Alliance-Focused Training: An Evidence-Based Guide to Negotiating Ruptures in Therapy (co-authored by Dr Catharine Eubanks, his close collaborator for the past 18 years) will be published in September 2025 and is the culmination of his work since the early 90s. “Emotionally, this was the big one for me. This is the child that hasn’t left the home yet, but it’s leaving home now,” he smiles.

Scratching the surface

Muran has no intention of slowing down any time soon. Now dean of a school that has both an analytic and an integrative history, he relishes his work in teaching and mentoring, and he’s still heavily involved in research. Aside from more replication studies, he’d like to look more into how the personalities of patients and therapists affect and intersect in the negotiation of their alliances. “Should you adjust how you are or how you engage the other because of personality style or attachment style? And what implications does your own style have for the choices you make in relation to the other?” asks Muran.

He still sees clients for 2 hours a day, usually in the late-afternoon, but his first task of the day is writing (he tries to reserve 7.30am to 10.30am every day for this). It’s something he has always had a passion for: he was an English major as well as a psychology major in college. “As a writer, you need to carve out time,” says Muran. “I always remember anecdotes from Stephen King and Ernest Hemingway about the importance of structuring your day. That’s one thing I’m very protective of. And now at my age (63), I’m particularly good in the mornings.”

While there may be much about the therapeutic alliance that’s still left to study, Muran’s 36 years of research has certainly gone a long way to further our understanding of this crucial aspect of psychotherapy. Muran adds “there’s so much that we still don’t understand. I think it’s amazing – I’m amazed that in the early 90s when we were first presenting our research at various conferences, the rooms were so empty, and now the rooms are so full. And we’re still scratching the surface.”