Contact With Therapist During A Long Break In Therapy?

[Hashi]

I have to take a break from therapy for financial reasons. I don't know how long it will be, and at this point I'm thinking about arrangements for the next four months. By the end of that, I'll either be able to start again or I'll have to review what to do next.

My therapist has offered options like a weekly email (very brief - I'd write a couple of short paragraphs and she'd write a couple of sentences back) and/or seeing her once a month. My feeling is that these would be worse than nothing, because they could actually stir things up without going into anything in depth or with enough continuity. There's also the risk of miscommunications, which we've had some of lately, which are upsetting and a waste of time and energy to resolve.

This is not like a three week break for a holiday, when I'm going to soon be seeing her regularly again, so too little is OK for a short time. And it's not like having a miscommunication/upset that we can talk about in depth the following week.

The only purpose this sort of minimal contact could have is generally feeling supported and some accountability (for taking care of myself), but I think the potential disadvantages and frustrations are likely to negate that. I think I'd prefer no contact at all.

My therapist is concerned because of the extent of my anxiety and depression, but I'm used to living with those and have to do that during the week between sessions anyway. I think not having any contact with my therapist would reduce the ups and downs, at least.

Am I kidding myself?

If anyone has any thoughts on that, or would be willing to share their own experiences, I'd be grateful.

 

[nursenurse]

I am wondering if it is to make sure you return to therapy? Once we leave something, even if it was intended to be temporary, it becomes easy to stay away. You know yourself best , though, and I am sorry your well being has to have a dollar value. Makes me wonder how many are out there who can't afford treatment at all :( you still have here, though :) not a complete substitute, but it's something. For what it is worth, I would take what your T offers, try it for the 1st month and see. You can always not email her again.

 

[Pencil]

Makes me wonder how many are out there who can't afford treatment at all

ME! :D

Hashi my T let me stay in e-mail contact with her for a while, but I get the impression I have more abandonment and attachment issues than you, so it really is a very individual thing.

 

[Jacnic]

Hashi, as someone who has no option but to work with my T via email and Skype (she is 8000 km or 10 hours flying time away), I can attest that it does not make things easy. It is really frustrating to ask questions and not get an immediate response. I often find that I have already done some more processing and moved on from the question, by the time I get her answer/suggestion....... However, having said that, if I can choose not to take these complications personally, I do find that knowing that someone is keeping an eye on what I am thinking/doing, even at a distance re-assuring.

Ultimately, I am responsible for my own progress, but she is there and will let me know if she thinks I am missing something, or going off the track. So, when I do some journaling, drawing, etc, I just buzz them to her in an email (journaling and drawing on the iPad makes this really easy), trying hard not expecting a response very often. Sometimes this is easier than others.

It works well for me most of the time, but the distance becomes a problem when I experience a trigger, or if I get into an emotional overload spiral. Then it is tough.

 

[quaintpapercut]

Hi Hashi- I think you know yourself best and what would be the most suitable for you. However, my instincts are screaming that you should take the option of brief email contact :). Like another poster said you can always discontinue it if you find that it is not helpful, but I think its important that you maintain some sort of link to your therapist.

The only purpose this sort of minimal contact could have is generally feeling supported and some accountability (for taking care of myself), but I think the potential disadvantages and frustrations are likely to negate that. I think I'd prefer no contact at all.

I would really examine your statement above. You state first that the purpose of it would be to feel generally supported and have some accountability (fact?), but then you argue that the "potential" disadvantages make it not worth it (not yet established).

I think the fact that your therapist is concerned for you and is extending this to you is important. I understand the all or nothing thinking because it makes it easier to compartmentalize things though.

 

[Lucycat]

I have come to the end of regular therapy, but the door has been left open via text and email. I last saw T about a month ago, and since then have sent and received one text message. It gave me the reassurance I needed to carry on, what I was doing. It was only a silly thing troubling me, but his reply was invaluable. It did not make me or him think we needed to restart therapy.

I think if I were you I would accept the offer of contact, but use it as needed rather than to a schedule. I guess I see it as a kind of safety net.

 

[Abstract]

i Hashi,

Two things occur to me. The one is that possibly the way you have handled attachment in the past is to create distance as a way of survival. If there is distance then there is less feeling of vulnerability. Sometimes a complete break can feel easier if that is your general past pattern.

The other is that if you are destabilised enough then doing that may very well be your best bet. I think only you can tell where you are with this. My instinct is to say that keeping contact is a step forward. But that this may not be the time or place for it. This stuff can be very destabilising and as you said when the pressure is up then misunderstandings can happen more easily.

If it was me what I would do is put aside what others may think this means and look at what you feel you can cope with . If you think you can possibly cope with ongoing contact then that is great and its worth a go. If not then I think you need to make do and then re build when you can. I believe you can and will do that.

 

[Hashi]

Thanks for your responses.

I'm finding it hard to understand what I really think or feel about it.

Everything's too messed up by the most recent upset we've had, which was about my therapist coming up against a therapist issue around working with trauma (she says that herself). Great if she's learning and growing as a therapist, but why was I funding that and going through the aggravation? She's not a trainee, she's qualified, experienced and supervised. It shouldn't even have happened.

If there wasn't a financial issue, I might be considering a break anyway, because of what's just happened. I'm really bothered about it. And in that case I'd want a complete break, not partial contact, but then it would probably only be for a month.

Maybe I'll ask to start with no contact, but with the option of sending an email if I need to, either occasionally or once a week. The other way round (starting with emails with the option of stopping) seems too dramatic and would probably concern her. I'd be unlikely to be stopping because I was feeling OK, more likely because I wasn't OK and it was pointless to write emails. I don't want to have to bother about someone else on top of how I'm feeling. (Please take my word for it that emails wouldn't help in that situation.)

I think no contact might make me more willing to return to therapy when I'm in a position to.

You state first that the purpose of it would be to feel generally supported and have some accountability (fact?),

It isn't at all a given that I'd feel supported. If she says something unfortunate, or I take something the wrong way, or if she doesn't comment on something I thought was important, or sends a bland response, then I could end up feeling the opposite. Someone caring about me or monitoring me doesn't in itself make me feel supported. In fact, it can easily be a negative thing for me.

It is really frustrating to ask questions and not get an immediate response. I often find that I have already done some more processing and moved on from the question, by the time I get her answer/suggestion

... and this as well. (Jacnic, I'm glad you're managing to have therapy like this, but I can imagine the difficulties.)

Accountability is the strongest argument for it. The possibility of it being more negative than positive is also strong.

It's really miserable trying to think about this.

Thanks everyone for your input though.

 

[Abstract]

Hashi,
I understand you saying that it is hard to feel what is up and what is down at present. When things are very emotive and different conflicting issues involved then it can be hard to see things clearly.

I also understand how contact of this sort could, for you, not be a short term stabilisng influence.

It sounds like you are saying that:
* You have lost trust already and this dynamic would be likely to strain things further and be destabillsing.
* You are struggling to come to terms with the financial pressure that limited funds put on your relationship with your T and that that is likely to continue sabataging things as you won't have the necessary contact to resolve things.

I cannot tell from what you said but it is also worthwhile considering some other possible simultaneous influences in situations such as this:
* Subconscious pushing away from the therapist as a means of feeling safer.
* Pushing away the positive of the therapist as means to feel less pained about distance. In other words splitting.


I have to say that for me ongoing contact such as this would be complex and difficult. I would not do it to find stability and if I did it it would be to keep connection to therapist and attempt to hold onto a level of trust.