Early Termination Of Therapy: Therapist Retiring Prematurely. My Anguish.

[Suzetig]

I don't think a client needs to know exactly how to deal with the end of the relationship and of course the therapist needs to offer a safe place for the client to work this out. Attachment issues however manifest themselves very differently in each individual and the client does need to communicate some of this to the therapist - guessing at what they think might be happening isn't a great basis for a treatment plan.

For example, I have abandonment issues which mean I pull out of relationships if I think I might have done something wrong - i can also be very anxious and upset and take this out on my therapist. At some point i need to be able in some way to communicate what my withdrawal or emotion is about for my T to "step up" and help me. Otherwise she could misinterpret what's happening and be quite ineffective or even hurtful.

I also think sometimes it's for the T to provide a space for the pain and rage and chaos we can feel when people leave us or let us down. Being there, holding a space and hearing all those feelings is valid ending work - I guess it's hard because it's a hard process but I don't think client in pain necessarily equates to ineffective therapist. Sometimes it does, but not always.

 

[lostforgottensoul]

I fully agree @Suzetig, you need to communicate things to a therapist.

For instance, my therapist reads my body langage and micro expressions but that only gives him info like we hit a hard spot or im not trusting him at the moment or am or even certian emotions but he didnt know that i was having different attachment issues at different times. Some i was attached too much but judging myself for it, several times i pushed him away. And though he felt the push and pull, he didnt know why or the specific issues we ended up going over or why i was having the specific emotions he was reading.

In addition, most therapist dont read both body langague and micro expressions and my emotions was mostly shown in micro expressions than body langage so id think its safe to say that most therapists would need more communication around emotions and my own therapist only knows the emotion is there but why, unless obvious, he will start questioning around it. So id say better communication of "i feel this" and "im thinking this" is needed.

Theres a lot of additional info they need to properly do their job.

 

[Deleted member 12723]

I have a question, is it possible for your therapist to have some referrals for you that he likes and prepares you to continue therapy with a new therapist?

I think that this is very important and will be good for you to have closure with your therapist after you tell him how his leaving is affecting you. I wish you the best.

 

[Deleted member 33880]

Goodness, all of you have given some really helpful answers. I am very grateful. I really am. some really sound advice and insight here on this thread. Thank you. .

I have been quite disruptive in my own therapy at times. If my T hadn't recognised this as part of my attachment and emotional regulation issues, I would have successfully quit prematurely a long time ago and put it down to another failed relationship wherein I just can't risk trusting another.

Oh, I can so empathise with that.

I went into the session bearing gifts, (flowers from my garden, some home made humous and pitta) which was really a peace offering and an attempt to nudge into a more caring space. ( I haven't really given him anything in a while - I occasionally give him something I bake but I so rarely bake it almost never happens. ) But as soon as I am settled and those gifts handed over, I am verbally pounding at him again about the abandonment stuff and how he is not helping me. He just seems baffled. In the end, I decide to just tackle the monster in the room and say "I love you and it really hurts that you are leaving me and I am not ready, I am not in the termination phase yet but you are leaving anyway. I don't know how much of the therapy we have done will get destroyed by that and I don't know how much of the relationship I have had with you will get destroyed by that. I am disintegrating with the betrayal. I don't understand how you can live with yourself for doing this. I have had six years of therapy with you and I wanted to end between 2017-2018, tailing off in that year to sessions once a month. But you decided to bail out on me summer 2017 (agreeing I am not ready) but you are keeping another therapy post in another place so seeing other clients. . I am so hurt that you are discarding me like this, whilst you know you are the first person I have attached to as me the younger self."

(I felt very courageous as I was shaking when I said all this)
He then started crying.
No kidding.
He hardly EVER cries.
He was so overcome with emotion that he couldn't speak for a while.
I was in shock.
really.

Then he manages to explain, rather brokenly, that he cries sometimes because of what this is doing to me, that he can't sleep at night, it is keeping him awake, he just can't cope with it all.

I am stunned.
I am speechless.

He continues sobbing. It is like HE is in breakdown. Every now and again he wipes his nose on his sleeve and mutters "I shouldn't be doing this, I am sorry, I am so sorry, I know this is not appropriate for you, I just can't seem to stop crying'

I then have multiple responses happening at the same time:

1. Poor man. He is really suffering.I love him, I hate to see him upset
2. He cares about ME THAT much?!?!?!
3. I am a bad person and he finds me too much and he can't even cope with doing therapy for me because I am so awful and bad and I must be much more good from now on.

I tell him the last one first. He insists that I mustn't think that, there is nothing wrong with me. I beg to differ. I have such severe abandonment issues tha tI go into meltdown even if he tries to reduce my session times never mind END with me.

He says that he HAS to reduce session times, he HAS to abide by the dictates of the NHs centre manager and he is struggling to do what he is being told to do.

He knows that I am finding it hell and yet he has no power over reducing session times and how often he sees me. He is being made to reduce all clients sessions. I just find it sickening.

It upsets me so much.

anyway, he is genuinely struggling still and upset so I suggest that he think of the ending as him walking the little girl in me, towards an ending which he has prepared her for, he is holding her hand and even when she gets to the door - he still holds her hand - in a way he will always be holding her hand. Something like that.

He said he would try to do that.

I told him I hate being so powerless and he has to find a way to help me feel that I have some control here.

I asked him to be more positive and upbeat about caring about me and say some nice things to me now and again like he used to. I miss the therapist who used to say loving kind things to me and make me laugh.

He asked me to be kinder on him and help him, he is in a position where financially, work wise, relationship wise and home wise, he has to stop doing this job next summer.

He also asked me to go with the timetable of cutting down of sessions as much as possible as it is causing him grief on his end with his work managers.

I came away feeling that I can feel how much I love him again. I told him that. I haven't felt love for him for about six months since this ending situation blew up. so that was progress. I want to end well. I kept saying that over and over again. I actually kissed his hand as I was leaving (something my little younger self would do) it made him smile but it made me anxious as I thought I was going to be told off (there is a young part of me that is surprisingly affectionate). anyway, the ending is still looming - ten months to go. And no, the referral isn't happening as there is no one in this area to refer to. So I am looking at private therapists as someone suggested. I have two appointments booked for next month. I also have a life coach and an acupuncturist on board. I am also doing yoga and meditation and qi gong again, so that will help.

Strangely I feel quite positive just now. Possibly because my young small self is happy to feel the love for him again and doesn't really understand that the ending is still going to happen, she is just happy he is back 'here' now and she liked her cuddle today. Also, I got exhausted from extreme abandonment trauma triggers that went on for ten days and I am only just coming back to 'normal' and so when I am feeling more normall, I forget how bad the bad can be and when I am bad I forget utterly that I can feel okay. So right in this moment, I feel good and so I don't imagine that I could feel pain if I lose him. I just feel fine in this moment.

Does any of that make sense? comments much anticipated. I think you will all have a lot to say!

 

[Suzetig]

There is so much about this that makes me concerned about how he is working. He shouldn't be crying in your therapy, acting out his difficulties in what he's being asked to do with you or asking you to go with it to keep him out of trouble. I struggle with you ending up in a place where you're reassuring him about how he might see the ending - it's his job to hold you, to deal with your feelings and help you. If he is honestly struggling with the ending work, and it would be natural for him to have feelings about this part of his career ending, he should be taking that to his own supervision not bringing it to clients - it's not for you to help him with his feelings.

Ten months is a good long ending period with lots of time for him to help you work this through, I feel that for him to blame his workplace for how you're ending is an abdication of his responsibility. It's ok that he wants to retire and that therapy needs to end because of his life plans - that happens in relationships and his job is to help you cope with that so that you have a model of good endings to draw on in your other relationships.

Is he an NHS therapist? If so the NHS remain responsible for your treatme when he retires, what has he proposed for continuity of your care? Again 10 minths is a long time, they should be able to find a replacement for you and id expect him to be pushing them to do just that.

 

[Deleted member 33880]

I thought someone might call him out on crying in my session. I actually felt better that he cried. He had been emotionally very blank for months. I felt that I mattered again today. I am not just a difficult client, I am someone that he cares about.
but I am not very good at spotting bad therapy - especially when the young part of me is relating to the therapist as the safe and lovely daddy. she never sees the daddy therapist as wrong, it is always her fault..
Yes, you would think that the NHS have a duty of care for me. Well, don't hold your breath. the cuts are so bad around here that I would be lucky if they just allocated me a support worker to talk to on the phone once a month. No thanks.
He might be very uncomfortable about today's session. I do know that my transference is very very strong and he can get pulled in. He is experienced, he has been doing this job 30 years. But he is also a very bog standard therapist and has only done six sessions of therapy himself. He is actually a psychologist.
He has been very very exceptionally kind to me over the last six years. He has hung in here when others have fled.

 

[Suzetig]

A psychologist is different from a "bog standard" therapist in that their training is very different in the UK. Frankly it sounds like he's lost his place in the therapy.

I can understand why it felt better for you to see him cry - it affirms the part of you that needs to be special to him and for him to finding the ending as difficult as you are. It's ok for you to want that, but he shouldn't be feeding it. The way it reads, you ended up looking after him and that's not what you're there for, your session isn't the place for him to have his emotional needs met.

Simply put, while he may have feelings of sadness about ending with you, his feelings will be different. He's coming to the end of his career, seems to be being pushed through an ending process etc and those feelings are about his career and life stage. He likely has a number of clients to end with and his feelings will be all mixed up with that - that's not to say he doesn't care about you, but it's a different care than you'd have for a child, friend or relative.

For you, you've said part of you sees him as a father figure, there's transference at play possibly and you're vulnerable in a way that he - as a professional - isn't. I know you love him and want to think we'll of him but part of me is glad it's ending because there's a point at which the relationship gets in the way of therapy.

I'm pleased you seem calmer about ending, I hope it goes well.

 

[joeylittle]

There is so much about this that makes me concerned about how he is working. He shouldn't be crying in your therapy, acting out his difficulties in what he's being asked to do with you or asking you to go with it to keep him out of trouble. I struggle with you ending up in a place where you're reassuring him about how he might see the ending - it's his job to hold you, to deal with your feelings and help you. If he is honestly struggling with the ending work, and it would be natural for him to have feelings about this part of his career ending, he should be taking that to his own supervision not bringing it to clients - it's not for you to help him with his feelings.

I think I disagree, a little - but I wonder how much this is a US/UK thing.

In reading your narrative, @Kaluki, what I see is that you hammered into him with the (conscious or sub-conscious, I don't think it matters) intent to crack his veneer. And he allowed you to crack it.

Should he have? Ultimately, it's what the client - @Kaluki - believed they needed in the moment, and two thirds of the response from the client was positive. You, kaluki, felt empathy for him again (which is mainly what you were hoping for), you were flattered (he cares about me that much?), and the only negative response was essentially 'this is my fault, I'm a bad person'.

You talked with him about that, and it sounds like it got addressed correctly. You aren't a bad person, and you didn't make him do anything. He would have had to make a decision to let himself 'crack', as he did. It was his choice.

In therapist-speak, I believe it's called 'bringing yourself into the room', and it's a debated thing. How/when is it appropriate for a therapist to use their own, unguarded response - or, to use their own, real-life history, or their own, actual beliefs (pretty sure those are the three categories). It sounds to me like, in the end, this therapist made an OK call about it - provided that now, moving forward, you (kaluki) don't essentially ask for a repeat of that session, and that you adopt the triage-down schedule that he's asked you to adopt.

If you have any lingering concerns about him, you need to vacate them from your mind by next session, if you can - and if you can't, I'd suggest you spend some time working on that so that you can eliminate them. You don't need to carry his problems for him. If he's smart, he'll be setting up his own therapy to help him navigate what is clearly a difficult transition. In the US, the mechanism would be to re-connect with their last supervisor, and do what's called 'supervision' for awhile, which is just specific therapy geared around the caseload. If their supervisor is no longer living or practicing, they generally can go to their governing body, or inside their practice.

My opinion - depending on how it goes forward, this could have been a necessary and cathartic session. But if it repeats, or if you can't put aside your concern for him, you'll be having a problem.

You might want to collaborate with him on a series of topics for the remaining sessions - things/topics that you want to finish up or close out or just have a last conversation about. It's generally not possible to do all that in one session, and so, making an agenda can really help.

 

[Suzetig]

I think it might be a UK/US thing @joeylittle, in the UK therapists are required to have regular, monthly supervision throughout the whole of their career, and it would be expected that a therapist would deal with their feelings about their client work in supervision. That would include, for example, pressure to end client work in a particular way, feelings about retirement etc.

Using yourself, your own feelings, experiences and concerns is fine and can be incredibly important in the work but always keeping the impact on the client in mind. I wouldn't expect a therapist to need to be comforted or reassured by the client or to be asking the client to work to a schedule to stop the therapist being in trouble with their employer, those issues belong in supervision. For example, what if @Kaluki just can't work with the reducing schedule? The danger is that they don't feel able to say so, or to try to negotiate a different ending process because their therapist would be in trouble. Asking for @Kaluki to go easy on him has the potential to stop them from being able to bring all of their feelings to the session, because the therapist might find it hard to hear - that shouldn't be the clients concern.

Him saying that he's not sleeping at night and can't stop crying and can't cope suggests to me someone who is burnt out and couldn't contain his feelings in session, which is quite different to making a conscious choice to let the client see the "real" him.

I think you've suggested a really good way forward for @Kaluki, hopefully you (@Kaluki) will be able to move through the ending process less painfully having had that experience with your therapist).

 

[joeylittle]

in the UK therapists are required to have regular, monthly supervision throughout the whole of their career,

Thats really interesting. In the US, required supervision ends, and becomes at the therapists discretion.

I'm more inclined (now) to see him as having crossed some boundaries.

But, I do still believe it can all get back on track. Sending you good thoughts, @Kaluki - I hope this is all helpful.

 

[EveHarrington]

I'm not so sure that even having therapy until 2017-2018 would result in a much better departure given that at even 6 years in, your abandonment symptoms seem to be spiking to a 10.

It sounds like this guy is majorly burned out.

The sucky truth about life is that people come and people go-----rarely on our schedule.

 

[Deleted member 33880]

Thanks again, all of you.
I have had a night's sleep and still processing the session.
I am aware that I am extremely vulnerable as I am mostly very young in that room (in real life I am in my fifties but I have no real 'feel' of that when in that therapy room :( )
He has the power, as therapists do.
My ending schedule (I gave him my timetable for it when he asked me to last summer. It took me two months to work out.) is not what we are following. We are following his. That always brings it back to him taking my control away.
Also, some of you in the US might not get this, but he works in NHS mental Health secondary care. For seriously bad cases. Primary care is like a counsellor and CBT and that kind of thing. Tertiary care is actually psych ward level. So - he kind of treats me like I am 'madder' than I am. Sometimes. He would vehemently deny that. But I worked with private therapists earlier in my life , and they treated me with much more dignity and respect. Things were done respectfully. In NHS secondary care, there are mental health trusts which are underfunded, so nobody actually gets what they need and so most people get very desperate and more ill, from what I can see. It also has an ethos of us (the professionals) against them (the service users) which is very weighted.

Anyway, how do I feel about that session now nearly 21 hours later?
a bit confused
He probably doesn't get enough supervision and his supervisor if he can get hold of her (NHS cuts under this present government, - don't get me going on a rant here) she often is very strict and tight and probably disapproves of most that he does with me. I am not sure she would be a whole load of help. It is probably her telling him to start dropping sessions or shortening them ASAP.
I think one of his failings is that he is actually a genuinely kind man. Sensitive and gives a lot of himself in therapy.
His shortcomings are that he hasn't had more than six sessions of therapy in his life, he is a psychologist (unconsciously feels he is important and knows a lot more - though he would argue with that) and that he admits he has never felt as deeply involved with a client as he does with me. I guess my deep traumas and my long six years of work with him would provoke that in him.
Of course little me is very relieved that he cares about me that much. She was so relieved that he was being real and authentic and emotional and not all woody and detached. But I am also aware that at some level he choose to cry. And then once he got going he couldn't stop. (he has done this once before some years when I railed at him for session after session using all my adult skills to find his sore spots. It immediately stopped me pounding at him.)
Of course, one of you pointed out that I am now in the ' I can't be angry at him' position. Like I was in my birth family. The same. I had to be good there. I have to be good here now. I am not allowed to feel this upset and this angry and this confused. It is too much for my therapist.
So from that point of view, ending with him is good.
I wish I had some people's confidence about finding another good therapist to work with - as some people here who know the situation do wonder if our therapy together has run its course and I have grown out of him but little me of course can't bear him going.
god, therapy, wish it is was more simple than this.
I just read an article that I really like - I read it years ago and then found it again last week
http://howtherapyworks.com/attachment-to-your-therapist/
You are all very perceptive, I wish I could reply to each of you individually but as I am sure you recognise, I am pretty swamped with all this that is going on. But I am profoundly helped by your comments and I deeply appreciate the time you are each putting in to pondering this for me.