Ending therapy – and how to do it in the least painful way possible!

barefoot

Sponsor
I've been seeing my therapist for seven years. I think the time may have come for me to stop.
But I am really struggling with this decision and what it will mean. And how it will feel (it already feels incredibly stressful)

We've never had a clear treatment plan/specific therapeutic goals, so it's hard for me to assess how far I am along in terms of healing/progress etc as I don’t have clearly defined things that I wanted to accomplish or achieve in our work together.

When I first started seeing her, I was having a breakdown, I think. PTSD wasn't on my radar at all. I didn't know what was going on with me (dissociation, flashbacks, trauma responses etc) If you'd have asked me seven years ago if anything traumatic had ever happened to me, I'd have said no… Ha!

I'm now not having a breakdown and I understand a lot more about trauma/PTSD/my symptoms and reactions etc. I don't really full-on dissociate anymore. I still have low mood sometimes and anxiety. I still get triggered and have short term fall out from that. I'm still not very good talking about/expressing my feelings eg I make a point of not thinking about or talking about my mum (in and out of therapy) who died suddenly and unexpectedly three years ago, because it's still so shocking and painful and I can't bear to go there.

I'm not really sure how far along I am in terms of my 'healing' and progress and am therefore not sure how much (if anything!) I could still potentially achieve...

I am pretty high functioning (even when I was pretty far into having a breakdown) so it's not that I am concerned about not being able to manage/cope with my life if I stop therapy.

My biggest concern about stopping therapy is missing her and feeling very sad that she is no longer someone I will see and speak to. I think that maybe sounds quite silly and childish. But, I suppose, the thought of finishing brings up a lot of feelings of grief for me. The thought of our relationship ending is intensely painful; the thought of that loss makes me very teary.

That said: I'm not currently in a mental health crisis; I don't feel like I 'need' therapy in order to function; and I feel like our work has stalled (again!)
Much as part of me really likes the routine of seeing her and feels understood/accepted/validated/comforted/safe/calm in her presence...I also feel frustrated and, I guess, unsatisfied with our sessions sometimes.

I have raised my frustrations/feeling like we’re stalling with her before. We’ve discussed it, agreed some actions, refocused the work….and I then feel much better about things and there is a short term pick up…and then we slip back. Part of me wants to discuss this with her again to ‘give her a chance’ and try to make things better again – but we’ve done it so many times now and I sometimes feel that I’m wasting my money. It doesn’t feel ok to keep going through this cycle. I can’t just keep doing this…paying £100 per session to generally feel dissatisfied and frustrated even though part of me absolutely adores her and is devastated at the thought of not having her to talk to anymore.

I used to think that, when it was the right time to stop therapy, I would just ‘know’ and that the thought of leaving wouldn’t feel devastating if I was ‘ready’. Now, I think differently – I don’t think it will ever not feel this painful. Even if we worked together for another 10 years and I did another 10 years of healing ‘my stuff’…I think saying goodbye will always be incredibly hard and painful. So, this time, it may just be time to ‘rip the plaster off’?

My plan had been to go to this week’s session with a really clear focus for the session and a determination to be proactive about pursuing that topic and not get side-tracked, and then see where it took us. If it turned into a good, useful, productive session: great and perhaps this was a sign that we could get back on track. If we just ended up spinning our wheels though, I would raise that I think it’s time for us to wrap up. I’ve been getting pretty stressed about the upcoming session and my brain has been in overdrive thinking about how the conversation will go. I’ve been googling ‘terminating therapy’ like a wild woman and now feel totally wound up about the whole things. So, I’ve been getting pretty heightened about it all...

That was the plan for this week’s session. But my therapist then texted over the weekend cancelling this week’s session as she has to deal with a personal matter so is taking two weeks off. So, I’m now not seeing her until the end of the month. I think I may have lost my mind by then!

I guess what I most need help with is:

- How did you deal with feelings of intense sadness/loss/grief when ending with a therapist? Did you find anything that helped with this?
- If I finish therapy with my current therapist, it’s not my plan to look for a new therapist. I can’t therefore see that I will ever talk about my historical trauma stuff/PTSD again. I’m not going to start chatting to my friends about it or telling my partner about it. So, what’s that like? To just go back to never talking about it to anyone again? It feels a bit like banishing these topics to never being spoken of again….to becoming secrets again...which, when I did keep these things secret for 25 years, and my therapist was the first person I finally told when I was in my late 30s, that feels like an unhealthy step backwards…but, I suppose, that may just be for me to re-frame?
- If I decide to stop, is it better to just stop rather than fade things out? I’ve already switched from weekly 90 min sessions to fortnightly 60 min sessions to save money after my income and health were hit by Covid. And, in fact, over the summer, sessions have been less frequent than that… I don’t know that reducing session frequency further, or having multiple sessions now focused on finishing, will lessen the pain of the goodbye…just extend it…so perhaps ripping off the plaster and just stopping abruptly is the best way? But it does feel a bit brutal to do that? Would be interested to hear others’ experiences with this.
- How do I not lose my mind in the run up to my next appointment since I know have two weeks to wait to get all this out, rather than two days?!

Sorry this is so long. It all just feels so....complicated!

No lectures please about therapists not being our friends, therapy being a professional relationship not a personal one etc – I’m very aware of those things and that’s not what I’m talking about here. And please no comments along the lines of ‘therapy isn’t meant to last forever’ (I know!), ‘I never understand how people get this attached to their therapist…’ or ‘I never felt this’ – I’m happy for you if you didn’t, but I don’t think that’s going to be helpful for me to hear right now!

Thanks!
 
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Geopolis

Confident
@barefoot thank you for sharing your current thoughts on this! While I've had many "professional" therapists I've also been lucky enough to connect intimately with the one I have now. This is my second time returning to him.

The first time we parted I had found a community of like minded people to recover with and ran out of money for my T.

The second time I was desperate for direction that I could no longer find within that group.

This time I am looking for same... I followed his direction and maintained our goals but eventually more was uncovered and I needed his eyes again.

IMHO its a gift to connect on a level that you would miss this person. I missed Allie. It hurt not just because he was gone but our dedicated time together was also missing and I feared not being goal oriented anymore. Leaning heavily on my network was extremely important for me.

When I left the second time our conversation was all about my decision to leave and my plans. He pointed out that this road winds and curves in unexpected ways and that his door was always open for a "tune up" or anything else. Bringing my decision up at the beginning of our session gave him the opportunity to help me frame it a bit better while reminding me of how far I had come.

Now I'm back and we're both putting in our best work but I'm sure I will have a very difficult time leaving him again when the time is right. You've done some amazing work! I hope my experience helps a little. 😉
 

Mach123

MyPTSD Pro
Hi I wanted to say I feel exactly like this. Idk what to do about it. I’ll never tell anyone else . My partner is very understanding but she’s not a therapist.

It’s brutally lonely imho which is probably the biggest barrier . Idk how to say this but it’s like so intimate and you feel like I’ll never have this again.

I don’t know how to say it but it’s like going from a committed relationship and taking the chance of having no one. That’s a big gamble in my case because I’ve gone longish periods with no one.

That kind of intimacy just isn’t that easy to come by in my experience.

So I really identified with your whole post and I could have written something very similar. I know it’s hard. : (
 

Skywatcher

MyPTSD Pro
I had this type of discussion with my therapist today. I asked her what it would look like if she retired. I have pretty intense abandonment issues that we are always working on. She said that some therapists out there completely close the door at termination. She doesn’t do that. She plans to still be there for me as needed if I were to leave. She made it seem as though she wasn’t planning to ever retire, but even if she did, she would be open to a professional email. (My example was if I had questions if she felt my new therapist were right for me). It was very comforting to know that she would remain a secure base for me as long as she was physically/mentally able to. She also said that I might get to a point where I would no longer need her at all. Maybe a conversation like this with your therapist would get you some answers that would make it easier to leave?
 

barefoot

Sponsor
It hurt not just because he was gone but our dedicated time together was also missing and I feared not being goal oriented anymore
Yes...I'm not really concerned about not being goal orientated if I end therapy now, in the way that you describe...but there is definitely something in missing her AND missing the time/space to hold the stuff that's hard.

Leaning heavily on my network was extremely important for me.

By 'network' and your earlier reference to 'a like-minded community', do you mean something like a peer support group or a group where other people had mental health struggles or something? Or, do you mean a friendship group? I have friends. And I have a wonderful partner – we talk about a lot and are very supportive of each other. But the deeper, harder stuff that I talk about with my therapist....where does that go?!

It’s brutally lonely

Yes, that's a spot on way of describing it. Even if it's not a topic I need to discuss in a particular session or even if I go months without needing to explicitly mention it...it just really means a lot and matters that my therapist knows it and is sort of holding it with me even if we're not talking about it. To not have anyone know that stuff...it feels like a step backwards....it's just me keeping it to myself again... But, at the same time, it doesn't feel appropriate to share it with friends/partner. I don't want to do that. And it makes me wonder, if I don't have anyone knowing about it, holding that with me and being there for me to talk about it with them if I want to....I don't know how I make further progress working on that old stuff on my own?

It was very comforting to know that she would remain a secure base for me as long as she was physically/mentally able to.
I'm glad this helped you. I'm sure my therapist would keep the door open for me too. And that is somewhat comforting, I guess....that there is an option to return if I ever wanted to, so it doesn't have to be final-final.

Maybe a conversation like this with your therapist would get you some answers that would make it easier to leave?
I brought it up towards the end of last year – brought up some frustrations and that it feels like we were lacking focus and the work was stalled. Said I thought it might be time to start thinking about stopping. It obviously took her by surprise. She said about how much progress I'd made and that we were still doing important work....so, if I decided to stop my sessions with her, she really hoped I would find another therapist to work with so I could continue my journey. Said she would be very sad if I ended but that she would fully support my decision, whatever it was. And then we talked through some of my frustrations with how therapy was going and what wasn't working for me and we agreed to refocus the work and how we could do things differently. It really re-energised the work and our relationship and things really picked up. But here we are again...same situation....same things I would bring up...same dilemma I find myself in. I don't know how many more times to go through this cycle...I mean, I could....but I don't know whether that's stupid of me?
 

Skywatcher

MyPTSD Pro
Yes...I'm not really concerned about not being goal orientated if I end therapy now, in the way that you describe...but there is definitely something in missing her AND missing the time/space to hold the stuff that's hard.



By 'network' and your earlier reference to 'a like-minded community', do you mean something like a peer support group or a group where other people had mental health struggles or something? Or, do you mean a friendship group? I have friends. And I have a wonderful partner – we talk about a lot and are very supportive of each other. But the deeper, harder stuff that I talk about with my therapist....where does that go?!



Yes, that's a spot on way of describing it. Even if it's not a topic I need to discuss in a particular session or even if I go months without needing to explicitly mention it...it just really means a lot and matters that my therapist knows it and is sort of holding it with me even if we're not talking about it. To not have anyone know that stuff...it feels like a step backwards....it's just me keeping it to myself again... But, at the same time, it doesn't feel appropriate to share it with friends/partner. I don't want to do that. And it makes me wonder, if I don't have anyone knowing about it, holding that with me and being there for me to talk about it with them if I want to....I don't know how I make further progress working on that old stuff on my own?


I'm glad this helped you. I'm sure my therapist would keep the door open for me too. And that is somewhat comforting, I guess....that there is an option to return if I ever wanted to, so it doesn't have to be final-final.


I brought it up towards the end of last year – brought up some frustrations and that it feels like we were lacking focus and the work was stalled. Said I thought it might be time to start thinking about stopping. It obviously took her by surprise. She said about how much progress I'd made and that we were still doing important work....so, if I decided to stop my sessions with her, she really hoped I would find another therapist to work with so I could continue my journey. Said she would be very sad if I ended but that she would fully support my decision, whatever it was. And then we talked through some of my frustrations with how therapy was going and what wasn't working for me and we agreed to refocus the work and how we could do things differently. It really re-energised the work and our relationship and things really picked up. But here we are again...same situation....same things I would bring up...same dilemma I find myself in. I don't know how many more times to go through this cycle...I mean, I could....but I don't know whether that's stupid of me?
Maybe this is how it goes? Relational therapy is somewhat “relational?” I guess the real question is what your viewpoint on therapy is. Let’s pretend you are investing in a personal trainer. Do you want that to be life long? There is always something humans can work on. However, you may view therapy as something more goal oriented? My therapist does emdr. Down the road I have considered working with a somatic therapist (if I can ever get over my fear of touch—oh wait, that was the reason why, lol). I don’t know. Maybe you already know your answer and you just need to try it on your own for awhile? Maybe start with a six week trial? —that’s how long they tell us to keep our college student at school before they visit home. It gives them adequate time to adjust and connect with their new world.
 

Geopolis

Confident
By 'network' and your earlier reference to 'a like-minded community', do you mean something like a peer support group or a group where other people had mental health struggles or something?

The first time I saw him my network was N/A since my struggle was with addiction then. Just being able to relate to them and hear their experience was crucial for me.

The second time was for deeper issues so I latched onto a network in ACOA (adult children of alcoholics), again they were there for me anytime with an open ear and mind.

Now I'm building here, on this forum, and in a couple other places because I can't spot self deceit and I need people around me that I trust. Even after a decade clean I need a few close people to bounce my issues off of and they always see something that I missed. In my experience, a community where I feel valued and valuable is without parallel. With all of your insight and experience I believe you could be instrumental in the growth of others while building a foundation for yourself. At least that's how it has worked out for me 😊
 

barefoot

Sponsor
@Skywatcher - Well, I don’t have specific goals that have a clear end point where you can easily measure success or identify whether the goal has been fully, partially, or not at all met.

What we have is agreed contexts/broad focuses for the work. So, for instance, currently working on managing triggers better.

I’m not a big fan of goal-setting - for myself or when it comes to setting goals for others at work. I find it constraining and restrictive. But I suppose that lack of specific, tangible goals means that it’s harder to measure progress. So, that is a down side.

I’d be able to do 6 weeks. I usually do fortnightly sessions but sometimes longer gaps. It’s not that I think I can’t manage without therapy. But there’s a difference between waiting x number of weeks before you know you’re having another session vs making the decision that you’re stopping for good and saying goodbye to someone important.

It’s those feelings of loss and grief that I am struggling with…not can I function ok without therapy.
 

mylunareclipse

MyPTSD Pro
I haven’t reached the end of therapy yet. 3 years with one therapist 1 year with another one and 1.5 years with current one. But, was wondering if maybe the longer spacing between sessions is actually what’s making the sessions stall. I feel like if I had so long between sessions I would find it hard to do meaningful work. But you might also be actually to just move on and you might not be able to afford extra sessions anyway, so maybe this is not that useful. Either way, I hope things work out for you and your T at least allows you to keep in touch in the long term Ie via email once in a while etc. mine have and it’s been great to not suffer as much from the loss of the relationship.
 

grit

MyPTSD Pro
It seems to me @barefoot that maybe you have not finished yet...and the real work is when you can integrate outside barefoot who is capable with in therapy barefoot who needs a person to hold her secrets. The mere fact you may be afraid to discuss termination without termination is or at least should be another difficult topic to tackle.
There are imho few topics that you and your therapist danced around without digesting to make them your story without the fanfare of PTSD/trauma boogey type issues.
Talking about your mother'passing... grieve has not started yet.
Learning how to tell your story to real friends, partner or anyone you feel connected without losing your mind, no shame owning your story that made you today who you are.
Taking power and using your strength to discuss any topic without a fear of therapist.
Any fear if the therapist is transference...why would an adult be afraid if another adult in supposedly safe space? Most likely we are triggered.

I left few therapists in my life for many reasons and during deeply disturbing work...and what I learned for me is that-
We need community- group of people who understands us .. my PTSD is successful site simply because of that.
I needed to be heard, understood and be apologized (weird last one) when wronged...and I got none of them but saw myself crying for it.the beauty is I saw myself crying for what I did not get in childhood...and sort of woken up to it.
I am starting now to see the transformation of my traumatic childhood energy to something else...just to have my unique subjective way of living...not what I was programmed to be.

It is painful experience no matter what...but any experience gives us both bad and good results. I am very sure there are many people divorced after long time with children and feel relieved though would not recommend.

I would recommend brace yourself to entertain termination with her and see what door opens or closes...keep an open mind for you!
 

scout86

MyPTSD Pro
A person probably doesn't have to be in an acute crisis to benefit from therapy. Over the past weekend, in the process of reading some of the many articles about 9/11, I was interested to read some articles about people who have been seeing a therapist for years related to their experiences that day. What they brought up, time and again, was that it helps to have someone they can talk about "stuff" with and there's really no one else they can talk to. They can't share with family members, really. Because mostly family members weren't there and don't "get it". (And, when you think about it, would you really WANT them to? What would that mean for THEM?) And, talking about stuff with other survivors can be helpful but sometimes the perspective of an apparently normal person is helpful too. So, even though they are functioning pretty well most of the time, a lot of them are working with a therapist. And the NYC fire department has increased the number of therapists they employ accordingly.
We've never had a clear treatment plan/specific therapeutic goals, so it's hard for me to assess how far I am along in terms of healing/progress etc as I don’t have clearly defined things that I wanted to accomplish or achieve in our work together.
I remember you mentioning this before. I can't remember what your T said when you talked about it. My T isn't a real "clear goal" kind of person either. If I asked him to help me come up with "clear goals", I suspect he'd try but he wouldn't be as successful as a different type of person would be. And yet, part of the reason I like him and can work with him in the first place is his personality. We have talked about "goals" a couple of times, because HE brought it up. When I couldn't come up with anything, he pointed out that it can be pretty hard to figure out what you want to work on if you have no clear idea of what "normal" is. (He avoids using the word "normal" but that was the gist of what he said.) I wonder if that's not kind of where you're at too? How do you decide what you want to improve when you've never experienced anything any different than where you've been and where you are? Maybe you could start by talking to your T about that? (I have a hunch that your anxiety about all of this is a sign that now isn't the best time to quit.)

If I was going to have this conversation with my T, I'd email him ahead of time to give him a heads up. Just because we both have a tendency to wander off topic (or to not HAVE a topic) and it would help us both stick to the subject if he knew ahead of time there WAS something specific I wanted to talk about. I'd probably be worrying about the fact that "we've had this conversation before". At least partly because, since we've HAD the conversation that means I should have it figured out. (So I'm WRONG and this is ALL MY FAULT! Not very useful....) That's just part of the process. I don't think there's really anything wrong with rehashing something until you really DO have it worked out.

What things make you think now is a good time to quit?
 
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