The client’s explicit expression of anger towards their therapist: a grounded theory study of female trainee therapists

This study aimed to understand the client’s experience of explicitly expressing anger towards their therapist. This research developed from there being little existing knowledge about these experiences from the client’s perspective, even though they are seen to present some of the most challenging experiences in the therapeutic setting.
The research was conducted through interviewing 9 female therapy clients using semi-structured interviews and carrying out the analysis using constructivist grounded theory.
The research found there were different processes at play that were present within the therapeutic relationship leading up to the explicit expression. The anger was experienced in relation to other emotions and was expressed in several different ways, resulting in mixed outcomes to the expression of anger.
Different responses from both the therapist and the client that were facilitative in enabling or disabling them to try to work through these anger events were identified. At moments of the explicit expression of anger, the therapist and client could get caught up in detrimental negative interactional cycles, which served to close down the therapeutic space or lead to a lack of connection through withdrawal. Consequentially there was little space for affective attunement and reflective dialogue, shaped by a rigid and detached stance, lack of humility, distancing interpretations and uncontained emotional or personal responses. However, in contrast, if the therapist and client were able to remain emotionally connected to one another during the explicit expression of anger and contain the process and engage in a reflective dialogue this could open up the therapeutic space to beneficial effect.