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

barefoot

Sponsor
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.
Yes, I think you're right and that longer gaps haven't helped with that. I dropped from weekly to fortnightly at the start of the year, which wasn't really what I wanted to do, but it was what was needed, financially. And it's worked ok. I did fortnightly sessions for about a year a while back and upped them to weekly 'temporarily' after my mum died, but the temporary arrangement just stuck until I couldn't really afford it anymore.

Fortnightly works ok. And, occasionally, we get into something and a fortnight feels too long to wait to pick it up again, so we book in the for next week. Due to a few reasons (illness, holidays, changing work schedules) I think I've had three sessions which have been longer gaps (3 or 4 weeks between sessions) and that does feel too long. I think monthly sessions could be fine if I just wanted to have a bit of a maintenance check-in chat. But if you want to get stuck into difficult stuff and, as you say, really dig in and do meaningful work, I think that's quite hard. Especially if neither of you are super focused and wander off topic a lot (which is what my T and I are both like!) It's also difficult if you do dip into something deeper to then think you have to hold on to it for four weeks before you can revisit it with T – more often than not, the topic then loses its importance/power over that time and no longer feels very important or relevant anymore, so these strands kind of fizzle out.

Its also why I don't want to sound very critical of T – it's not that I'm giving her full responsibility for losing momentum and sessions stalling. It was my decision to reduce frequency and I think she thought that was a pity as we were getting into some important stuff. I thought it was a pity too...but needs must. It's the annoying thing about work being quiet at the moment....I currently have a lot of time where I could be doing work on myself and could really try to crack on with some stuff....but, unfortunately, I have time, because I have little work and having little work means I have little income....so, while I have the time to potentially commit to more therapy, I can't afford it!

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.
Thanks. It would help, I think, if she were open to the odd message. Though I think I would feel like I had to reign myself in and resist the temptation...to not give in to my desire to message her. And I wouldn't want to be annoying.

The mere fact you may be afraid to discuss termination without termination

It's not that I'm afraid to discuss it so I won't discuss it. It certainly creates some anxiety, yes. But I was fully prepared to bring it up tomorrow. But now I won't see her for another two weeks. And I have talked to her about it before, at length, and we agreed a different way to move forward.

Talking about your mother'passing... grieve has not started yet.
There is plenty of grief, believe me! I feel completely devastated. I miss her dreadfully. The loss is incredibly painful.
I just don't see how talking to anyone about it will help. What use is it to tell my T it's unbearably painful and that I can't even express how much I miss her? I know how I feel. I don't see what difference it makes to tell someone else.

My T tries to encourage me by talking about the power of 'being witnessed'. I don't want to be witnessed. By her or anyone else.

Learning how to tell your story to real friends, partner or anyone you feel connected without losing your mind
But why would we do this? Why would it ever come up that we would need to talk to friends about experiences so traumatic that they caused our PTSD?
I may well be missing something....I just don't get that those conversations and topics would ever come up?

using your strength to discuss any topic without a fear of therapist.

I don't think I do fear my therapist?

We need community- group of people who understands us .

Yes, I guess that is what she is for me. And that is something I'll miss a great deal. As I mentioned earlier, just losing the person who knows and understands your stuff, even if you're not always explicitly talking about it or working on it.

A person probably doesn't have to be in an acute crisis to benefit from therapy.

Yes, completely agree with you.

it helps to have someone they can talk about "stuff" with and there's really no one else they can talk to. T

Definitely. T is 100% this person for me. And that's partly why the thought of ending therapy upsets me so much – I've never been great at talking about my feelings and I'm still not but have improved, I think....so it does feel like a bit of a step back to have worked on getting better at that to then make a change which means you go back to not having that person. (My partner and I talk about a lot of stuff, including some stuff that comes up with our therapists...but a partner isn't a therapist and I don't think it's desirable to try to be so)

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.

I think our Ts have a very similar style! Yes, she's not all about the goals. And neither am I. Even in my work, I always veer away from anything that feels too right and structured around goals or objective setting. So, it's not that I want a clear list of goals or a detailed, written out treatment plan or anything. Not at all.
But when it comes to trying to decide whether it's time to pause/finish therapy, I think it does make it harder to review progress and reflect on how far I've come/what else is there to do. And, I suppose, although I don't need that specific list or plan, I do want to feel that we're getting somewhere. Which really just means I need to feel that sessions are meaningful and useful in some way.

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?

Yes, that's a good question... I find it difficult to know what's possible...what I could realistically expect or aim for. Is it reasonable and possible to think I could work towards never being anxious or depressed again, for instance? I have got a lot better at handling medical appointments...does that mean job done because I have found ways to manage it, or does it mean, with more work, I could get to not feeling anxious and needing to manage it?! Could I ever get to the point where I don't feel so push/pull about my T?! Can I hope to have a sex life again?! I've no idea! I have said to her before that I don't know what's possible or realistic and that maybe I am currently just as good as I will ever get... Maybe that's worth another conversation.

(I have a hunch that your anxiety about all of this is a sign that now isn't the best time to quit.)
To be honest, September/October is always a time when I have a mental health wobble. Even before therapy. I don't know why, I just always seem to feel a bit destabilised and tend to have low mood and anxiety spikes. Now, early September is also the anniversary of my close friend's death and the anniversary of my mum's. So, it has become an even more emotionally heavy, triggery time.

And also, I have a lot of anxiety about the therapeutic relationship a lot of the time! The push pull of it, the laying awake until 3am fantasising about firing her, the vulnerability and intimacy in sessions... For a while, I concluded that perhaps THAT was the work for me to do in therapy...and when I told my T that she looked delighted and excited! As though I'd just had a huge revelation that was going to change my life! But my T is the only person I really feel those extremes with. So then it just felt nuts to keep going back to the person who seemed to be stressing me out...and paying her for the privilege too!

I don't know...


If I was going to have this conversation with my T, I'd email him ahead of time to give him a heads up.

I did do that last year when all this came up. And I think that maybe helped for the conversation to be a useful one. I considered doing so this time but then thought I'd go with an open mind and try hard to make it a useful session....and then I might not need to talk about ending, if it goes well....so then I wouldn't have needed to give her the heads up! But, if I'm in such a stew about it all, perhaps I should discuss it when I see her next time no matter what...? The thing now though is that she has taken two weeks off to deal with a family matter....I've no idea if someone is ill or has died or is dying or if there's been a big argument or whatever....and, of course, it could be something good....she did refer to it as having to deal with 'a minor family matter'....so that suggests a small thing...but then, it is also taking her two weeks away... No point in me trying to mind read, but whatever it is is serious enough that she's cancelled all her work to go away for two weeks to deal with a family thing...so then I thought I'd look like an insensitive arsehole if I emailed at this point to say I was thinking of leaving therapy...?

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.

Yes....there is definitely this! I feel like, if I email, not only might it be insensitive if she's dealing with something personal and I chuck her a message to say I think I might be done (though I know, I know – she gets to decide if she looks at work emails or not while she's on leave)...but I also feel a bit cringe because I think she might sigh and roll her eyes in a 'here we go again...' type way. Especially because it was about a year ago that we last did this.

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

If not now, when...? ;-)
But seriously....I don't know how you know or when is a good time...
It's been 7 years...
I don't have much money coming in (but hoping work will pick up in the new year) and she is expensive
I am frequently feeling flat and frustrated after sessions – that they weren't helpful or were just surface level chatty. So, I suppose I feel like I'm not really getting value from the sessions (which I guess matters more as the money is a stretch for me at the moment)
Maybe this is as good as I get


As long as they’re not dead I can still call them, from almost anywhere on the planet, and if we’re both local? I can set up a one off appt whenever the heck I want to, or even resume therapy.

I’m a hardcore isolator who has a tendency of just “walking away” from both their entire life, and aspects of their life. Chapter? Closed. Moving on.

Yeah...I guess I just think, if I call time with her, I should then make every effort to not contact her. Because, that's the point – I'm ending it. Like you, I am a walking away, chapter closed, moving on type person usually. I'm not friends with any of my exes. I don't still have friends from when I was at school or uni. There are few ex-colleagues I'm still in touch with. So, I guess for me, this decision does feel final. Because, if I'm ending a relationship, I'm ending a relationship, and the point is not to keep interacting with them again. Even if they're not dead or bad people ;-)

I also don't think it's fair or respectful for her, for me to leave therapy but then send her messages wanting to get messages back. Going back for a paid session is different....that's paying her for her time and her presence. Messages afterwards feel like I'm trying to get free time and attention from her. But going back for paid sessions mean that....well, the whole ending therapy thing didn't really work out! ETA: wanting to and actually keeping in touch after therapy would feel like a failure...and there is some shame there too, I think, around feeling a want to keep a connection going with her afterwards.

I could be sounding very black and white here, and perhaps that's something for me to think about...
I also don't think I generally 'do' endings. I am a bit of a ghoster....I jtend to just slip out of people's lives and let them slip out of mine! No arguments, no big discussions, no dramas...just, oh, there, see...we're not in each other's lives any more! With this, I would want it to be a conscious ending and one that I have communicated...after 7 years (or however many it ends up being) it would feel disrespectful and unprofessional for me to just ghost her. I don't think it would feel good for either of us. So, perhaps my discomfort with endings and the fact that I usually don't talk about them, I just disappear, is adding even more anxiety to this whole scenario. Probably.
 

barefoot

Sponsor
Actually @scout86 I'll add another one to the list of why this feels like a good time to quit; I feel a bit taken advantage of my my T. I feel that she is perhaps a bit complacent after 7 years of working together. And now I am only worth £200/month to her rather than the £600/month I have paid her for the last few years. I feel like, if she needs to move things around in her schedule, or she wants to be ten minutes late to a session because she fancies going and making herself an orange juice, or if our session is interrupted for a few minutes because her dog walker turns up...I feel like she thinks, 'oh, it's barefoot....she won't mind'
And while I don't always mind things like that – life happens! – they are happening quite a lot lately and it feels unprofessional and disrespectful to me. There's one thing being a nice easy going person (she's been late for pretty much every session for the whole 7 years and I'm generally not bothered about that) But I don't want to be a mug.
 

Mach123

MyPTSD Pro
I had a really bad day today and I actually brought this up with the therapist. I’ve thought about this thread a lot. Things have been going sideways and therapy today was just one more thing. I didn’t come away from it feeling warm and fuzzy.
 

scout86

MyPTSD Pro
I have got a lot better at handling medical appointments...does that mean job done because I have found ways to manage it, or does it mean, with more work, I could get to not feeling anxious and needing to manage it?! Could I ever get to the point where I don't feel so push/pull about my T?! Can I hope to have a sex life again?! I've no idea! I have said to her before that I don't know what's possible or realistic and that maybe I am currently just as good as I will ever get... Maybe that's worth another conversation.
I think all of that is DEFINITELY worth more conversations. Clearly you've made progress. But it's also clear there's more you'd like to work on, It's possible that you're at a point where this T doesn't have the skill set to keep helping you with what you want to work on. It's also totally possible she's up for it. (It occurs to me that finding that out is a little scary too. Because....well, "change" and all that?)

When I first started seeing my T, he talked about "ending therapy" some. He actually said, in kind of an off hand way, "Most people see me either 3 times or 30. I don't know why those 2 numbers, but that's the way it works out." He clearly meant that "most people" are finished with what ever they wanted to work on at that point. But he also has people who come back again down the road when there's something else they want to work on. When we got up around 30 sessions, I was pretty sure he was going to fire me. I mean, I SHOULD have had things sorted out by then, right? I finally asked him about it. He paused (I think because he had no idea I was worrying about this) and then said, "I said 'most people'. You aren't most people. In fact, you're the least fireable client I've got." (I have no idea how he meant that. Whether it's a good thing or a bad thing. LOL) The thing is, even though some sessions feel more obviously productive than others, I think I'm getting something out of the experience. And I think he'd bring it up if he thought I wasn't. Right now, money isn't an issue. I can see where it would add a layer of complexity if it was. (I have to admit, once in awhile it crosses my mind that he might be keeping my around BECAUSE of the money. But I THINK that's me being paranoid and having some attachment related issues. You know, no one could POSSIBLY want me around without some kind of ulterior motive, I just haven't figured it out yet. And, when I figure it out, it will be clear, once again, that I'm incredibly stupid. I think that might be what they call "a symptom". LOL But, maybe not....?)

I think you're doing a good job of thinking this through. I also think it's smart to notice the time of year and consider that it might be having an effect on your mood.
 

Mach123

MyPTSD Pro
I could really use a therapist now and mine is just frustrating the hell out of me with everything you mentioned in the OP. Then I blame myself and she takes advantage of that. I feel like at the end of the day I’m going to get depressed again after Becoming hopeful, and she’s going to blame me for not “wanting” to get well. It’s like life took a hiatus and I was supposed to get better during that time but it didn’t happen. Now here I go again. Times up. I’m still not ready. Half baked lol. This is how I felt graduating from high school. : (. This is a great thread thanks, I might have to hide it so I can stop thinking about it lol.
 

barefoot

Sponsor
It's possible that you're at a point where this T doesn't have the skill set to keep helping you with what you want to work on. It's also totally possible she's up for it.
Not sure how I’d know that. Whenever we discuss ‘the work’ she totally sounds up for it and seems confident that we can do it. Also tells me to trust the process a lot 🙄.

And yet, here we still are, treading water again…about to have the same conversation again.

I don’t know if that’s down to me or her or both of us equally.


I think all of that is DEFINITELY worth more conversations.

We’re good at having conversations ABOUT the work. So, I’m sure we can have more conversations and say we’re going to work on them and that will sound and feel very purposeful and intentional…but we just don’t ever seem to really get there… Again, not sure whether that’s her or me… Not that I’m trying to apportion ‘blame’…but it just makes it hard to work out what’s going on and what’s possible.

Feeling a bit calmer about the situation but only because I’m avoiding really engaging with it and I’m worrying about other things. I’ve still got almost two weeks to go til my session.

I wonder if the thought of the ending/the goodbye conversation is actually more anxiety-making and upsetting (or at least the same) than being without her. I’d been thinking not seeing her and missing her is the bit that’s intensely painful. And maybe it is. But now thinking, that last meeting, that final goodbye…the thought of that is excruciating.
 

Mach123

MyPTSD Pro
I’m sorry things are hard at the moment @Mach123 :(
Thanks I really appreciate your thread . It’s hard stuff but this helped me pull my thoughts together about the way it is in therapy. I have to “do something” about her, which really pisses me off because she’s suppose to be “doing something” about me, theoretically, and now it’s another problem. Oh well, nobody can get any help right now ! Lol.
 

scout86

MyPTSD Pro
Not sure how I’d know that.
Best of all possible worlds, I think SHE would know it. But we don't actually live in that world, I guess.

With my T, it seems like he goes way out of his way to make sure I feel "safe" (or "safeish" anyway) in our conversations. So he doesn't usually push a topic. And I tend to AVOID a lot of topics. Which makes it seems like we're not getting anywhere. Except that now and then we do and it actually isn't as hard as I expected. IDK. I think there's a balance there that's tricky to find. I know my T errs on the side of caution because he's worried about re-traumatizing people. Other T's don't seem to worry about that as much. When I read about experiences with them, it seems like they're "doing more" but sometimes I wonder if it's really constructive. (I honestly don't know and do wonder.)
 

barefoot

Sponsor
Best of all possible worlds, I think SHE would know it.
Yeah… I think she thinks I’m making lots of progress and that we are doing lots of therapeutic work…but I don’t always see it that way or feel it.

With my T, it seems like he goes way out of his way to make sure I feel "safe" (or "safeish" anyway) in our conversations. So he doesn't usually push a topic. And I tend to AVOID a lot of topics

. I know my T errs on the side of caution because he's worried about re-traumatizing people. Other T's don't seem to worry about that as much.

Yes, these things are very familiar. My T is definitely a softly softly, go gently, don’t crack a nut with a sledgehammer, let’s go carefully so as not to retraumatise type T.

And I am very avoidant (think she sometimes is too?) But I still want to feel that I’m doing useful stuff and getting somewhere meaningful with it. Not just rocking up for a bit of chit chat every couple of weeks or so.
 

barefoot

Sponsor
So, I finally had this session a couple of days ago.

When I originally posted, I was strongly leaning towards wrapping up therapy.

Then, as I had to wait almost three weeks for my next session, things settled and I managed to park thinking about it, so I went to my session the other day very open-minded and not really sure how to approach it.

So, we had a normal session. I was largely talking about some medical stuff that has been stressful recently.

As we got diaries out to book in next time, I mentioned that I’d been wondering again whether it was time to wrap up or to start talking about it, so I’d like us to talk about it next time. And she looked very surprised and said if I want to stop, we can stop. Or we can refocus the work and continue (which is what we did last time, a year ago) And I said I was totally open to either, that I hadn’t decided I definitely wanted to stop, but that, seeing as I’ve been thinking about it a bit lately, it feels like something I’d like us to talk about next time.

Said that I hadn’t wanted to email her a heads up as she was on leave dealing with a family situation. So, I was just giving her a heads up now ahead of next week, because I didn’t want to blindside her at the start of the next session.

Anyway - I think it just meant that I blindsided her the other day instead. And I feel like I then got a really defensive response from her.

She said that she wanted to share an observation: that in the last couple of sessions especially, I have talked a lot, and she has been unable to get a word in. Apparently, she had tried and tried but it was just impossible for her to make an interventions, because I was ‘bulldozing’ her. And she wondered if there was some avoidance in that.

And then she suggested I reflect on that til next time. I wanted to respond there and then but she said no - I’m to reflect on it and we can talk about it next time.

The thing is, she is right - I have a tendency to get on a roll and talk at her and, when I’m doing that, I’m difficult to interrupt. And I generally do it when I’m very anxious and/or avoiding.

So, this isn’t new insight. At all. We have talked about it loads of times over the past seven years of working together! I have said before that it frustrates me about myself and about how I get stressed in sessions and then do it more. I have said before that I realise that it’s sometimes that I daren’t stop talking about X because then we’d have to talk about Y.

So, her throwing it in as something for me to ponder and reflect on feels disingenuous. It just feels like BS.

It doesn’t seem to me that it was something for my benefit at all - for me to genuinely reflect on and get some insight from her nugget of wisdom.

It honestly felt like she was a bit surprised, and then assumed that my reasons were going to be that I wasn’t getting the therapeutic interventions I needed, so then she just leapt to defending herself, basically saying she couldn’t make interventions (do her job?!) because I was talking too much. It just feels like she leapt to criticise/blame me before I had a chance to do that to her. And that her comment was about her defending her skills as a therapist, more than a genuine opportunity for me to reflect and learn something new.

It’s also so bizarre to me that her perception of the previous session was me talking too much and her trying so hard but failing to get a word in. The way I remember it, she was late because she said she fancied an orange juice and so she went to get one, she was then really distracted and kept looking out the window and it didn’t feel that she was present or listening, then she suddenly turned her camera off and left for a few minutes because the dog walker turned up, then when she came back she was like, ‘what were you saying? Something about triggers?’ And I was really struggling to find an in to pick up from our last session doing a deeper exploration of family triggers. And I kept saying I don’t know what to say because I found the homework hard…thinking she would step in and say something…but she didn’t, so we sat in silence quite a bit until I tried again. And the only things she did say about it, she’d said loads of times before (like ‘your dad and sister are in a co-dependent relationship’ - said in a tone that suggested that this was a new insight and a revelation, when we’ve been saying it for at least three years!

I really wish I hadn’t said anything. I should have emailed her after the session instead to give her a heads up - at least then, if the email had triggered defensiveness in her, I wouldn’t have been there to be on the receiving end.

I feel really angry with her about it. It felt like a shitty thing to say, a shitty way to respond to a client saying they want to talk about potentially wrapping up soon, and a shitty way to end a session.

Having felt very open during the whole session until the last two minutes, I now feel very closed and disconnected.

Perhaps she was trying to make my decision easier…! Perhaps she has. And perhaps I don’t need to worry about there being a painful sense of loss, because she’s really pissed me off!
 
Top