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Is ‘You’ll know when it’s the right time to end therapy’ just a big myth? (And how do I unattach from my therapist to end therapy?!)

barefoot

MyPTSD Pro
I think it might be time for me to wrap up therapy. But I’m finding the whole decision quite confusing and I just keep going round in circles with it...

As a bit of background: I’ve been seeing my therapist regularly for 10 years now (way, way longer than I ever imagined I would – I initially thought I’d have sessions for a few months tops. Ha!)

In terms of my mental health, I feel in a really decent place. I still experience some anxiety and low mood, and still get triggered sometimes. But it’s manageable. I’m functioning well. Busy with work/my business. Certainly not in any kind of crisis. I don’t believe that, without therapy, I’m going to collapse or cease to function or that I’m going to fall apart, not be able to cope or have a breakdown etc...

With therapy - we’ve done some deeper trauma work over the years…made some big shifts (key one: I don’t dissociate any more)…but also always seem to stall with the deeper, trauma-related stuff. We make some progress….then sort of stop. And, I always thought we were working towards doing more on that stuff….and I thought she had a clear plan about how to help me with those things (she didn’t ever share a treatment plan, but she has always spoken so firmly and authoritatively about the things we will work on and what we will achieve - so I just assumed she had a plan!) But I realised in a session a few months ago that there is no plan. Which was disappointing. Quite shattering actually. And, without any kind of plan and with her now saying that some of those areas I thought we were working on…those things aren’t going to change (they are out of my control) so they are what they are and they will continue to be upsetting and stressful…and with the fact that resistance always seemed to come up anyway...it just seems pretty pointless now, me thinking that they are goals for therapy.

So - with those bigger, deeper, trauma-related topics off the table, it’s more just everyday stuff we have been checking in on lately. And, there is value for me in that. Even if we’re not talking about anything particularly deep or serious, I like having time and space carved out to reflect on myself and to talk through whatever’s going on (even if it’s pretty light stuff) I work from home and most weeks/months, my partner and my therapist are the only people I really have proper conversations with (I have work calls etc, but obviously not the same!) I do have some friends, but don’t see/speak to them often. And I don’t really get into serious chats with them when we do have contact. And I feel OK with that (I really don’t feel like I need more friends and really don’t want to start getting into regular deeper with chats with the friends I have etc) But, I suppose that context has maybe meant that my therapist has become really important. Because I don’t talk to many other people. Especially about how I feel. So, losing that (by stopping therapy) feels like a significant loss.

I am also very attached to her. It’s a weird thing with therapy, isn't it? That we are meant to build trust and relationship with them so that we share intimate stuff and the therapeutic relationship is supposed to be so crucial etc…but then, having built trust and relationship and intimacy, we’re then supposed to just turn the tap off and not be in relationship with them anymore.

I’m not overly reliant on her. I am not confused about our relationship (I’m very clear that it is a professional relationship - we’re not friends etc) But - she has been a really significant person in my life for a decade. And, while I think I will manage life without therapy, I will really miss her if/when I end therapy. And just the thought of losing that space, that relationship, having her to talk to…it is a very upsetting thought that makes me quite teary.

I always thought that, me feeling that way when I thought about ending therapy meant that I still had work to do and that it wasn’t the time for me to be wrapping up. I’ve also often heard people say ‘when it’s time to end therapy, you will just know.’ But I feel very confused about this. Because, over time, the distress I feel when I think about not seeing her for sessions anymore hasn’t reduced. It is still very intense. And I am starting to wonder if the whole, ‘you’ll just know…’ is a myth?!

I have mentioned the possibility of wrapping up therapy to her in recent sessions. And that has been a bit of a strange (and confusing experience) Because, she basically just says that it is my choice ie if I choose to end therapy, that’s my choice and she will support me (she said she would be sad about that) But she also said that I don’t have to put myself under the pressure of making a binary decision…that it’s not just about deciding do I want to be having weekly therapy now, or do I want to now permanently stop. She said things can be much more flexible and fluid. That, we could also pause, and I can just set up a session whenever I want. And she said that, even if we don’t see each other, the relationship (and the therapeutic container) is still there and still intact. So, I could contact her any time (in weeks, months, longer) to set up a session.

So, she was very much emphasising that a) it was my choice if I wanted to continue or stop and b) even if I paused/stopped therapy….I could still set up a session or a bunch of sessions any time in the future if I wanted to. And I think that was her way of trying to soothe some of the anxiety I have around stopping therapy. But, for me, it doesn’t really address the loss. And the pain of the loss.

Also, by being quite, ‘well, we could just pause and you could then just get in touch if you ever wanted to have a session’ - although that keeps it fluid and not so definitely final, which I think is good in a way….it also feels vague and woolly…and like there’s not really any intentional sense of wrapping up or completion about it…it just feels reeeeally open, with me just sort of drifting away not knowing if I’m stopping or not…

I thought the end of therapy would be…well...managed, I suppose. Managed and intentional and quite structured…reflecting on my progress, looking ahead to time without therapy….and doing something (I don’t know what….maybe spacing out sessions or something?) to work on managing the transition away from therapy and the therapeutic relationship. And, just generally, doing some mindful wrapping up.

I feel like I need to unattach myself from my therapist, but I’m not really sure how to do that. Or how I make this vague 'ending but not really but maybe…’ work. Or is this all a bit of a myth/BS as well. And, actually, those kind of endings don’t lesson any upset….they just draw out the process. Is it better to just do a short sharp, final shock - rip off the band aid?!

I’m not great at loss/endings…I tend to ghost people and drift out of relationships and had wanted to handle this one differently as it’s been so important to me and I suppose I wanted to honour that somehow. But I feel like my T is maybe as rubbish/avoidant at endings as me, hence this very vague ‘just pause and then get in touch some time in the future if you want to as I’ll still be here for you’ suggestion. (And, of course, a big part of me doesn’t want to stop at all, because I will miss her)

Any thoughts/suggestions/questions very welcome. It’s a confusing time.
 
Wow...I can so relate. I am in the same place (and have been for quite a while).

it’s more just everyday stuff we have been checking in on lately. And, there is value for me in that. Even if we’re not talking about anything particularly deep or serious, I like having time and space carved out to reflect on myself and to talk through whatever’s going on (even if it’s pretty light stuff) I work from home and most weeks/months, my partner and my therapist are the only people I really have proper conversations with (I have work calls etc, but obviously not the same!) I do have some friends, but don’t see/speak to them often. And I don’t really get into serious chats with them when we do have contact.
Yeah...I seldom anymore discuss hard stuff at any depth with my T. And I don't have anybody outside of therapy I talk to. That's the hardest part. My T and I just talk everyday stuff, and that somehow feels like I'm not "doing the work." On the other hand, what I'm finding is that I gain a lot of small insights along the way with what we do discuss. I'm still not in a great place, but I honestly think actual therapy has gone as far as it can.
She said things can be much more flexible and fluid. That, we could also pause, and I can just set up a session whenever I want. And she said that, even if we don’t see each other, the relationship (and the therapeutic container) is still there and still intact. So, I could contact her any time (in weeks, months, longer) to set up a session.
Mine has said the same. I get how it might feel weird if you are expecting the "normal" clean ending. But I see nothing wrong with it. Life is fluid, yes?
Is it better to just do a short sharp, final shock - rip off the band aid?!
Wouldn't be for me. For some, it would. I think you have to figure out what would be best for *you*?
But I feel like my T is maybe as rubbish/avoidant at endings as me, hence this very vague ‘just pause and then get in touch some time in the future if you want to as I’ll still be here for you’ suggestion. (And, of course, a big part of me doesn’t want to stop at all, because I will miss her)
Well, maybe, but just maybe she recognizes that circumstances change and you might need to talk.

I know how hard this is--I hope you find some peace in whatever you decide!
 
when it’s time to end therapy, you will just know.
I’m suspicious of any sentence that ends with “you will just know”!!

I’ve tapered from therapy every day, to now having a session once a month. I don’t have other spaces where I can really talk, and for me that’s important. Not because I usually want to, but because it helps me work through stuff that I don’t have anyone else to work through it with.

For me, if I decide I need less than that, I’ll reduce it further. And if something happens and I need more? I’ll go more.

Clear goals can definitely be helpful. Instead of leaving it up in the air, would it be more helpful to set up an appointment 3 months from now? Regular sessions to zero-support is a big change. And I can see that’s appropriate for some people, but I think for people who have been in long term therapy, a transition period is probably more helpful than that idea of yes/no, going/not going.

Going less frequently changes the dynamic all by itself. You don’t lose anything, but rather, you grow elsewhere and it simply becomes less.
 
Omg, I relate so much! And have been going through similar debates and views myself.
her now saying that some of those areas I thought we were working on…those things aren’t going to change (they are out of my control) so they are what they are and they will continue to be upsetting and stressful…and with the fact that resistance always seemed to come up anyway...it just seems pretty pointless now, me thinking that they are goals for therapy.
This is interesting. Are you ok about not talking about these things? And is it a fact that the resistance will always be the same? And that these things will never change? Obviously you don't need to share what these things are, but nothing is ever always exactly the same. Yes we can't change what happened, but there is always room for shifting how we hold things. It may not it perfect and peaceful, but it may make it less distressing?
Because I don’t talk to many other people. Especially about how I feel. So, losing that (by stopping therapy) feels like a significant loss.
I get this too and have been practicing telling my friends more about my feelings. And that's been going well. They check in on me and listen to me. I think it's taken a transition for them , and me, as usually I am the one their tell their feelings too. So allowing space for mine was a change we all had to get used to. Because I also felt that the space with T: she's the only one who really knows what happened and if I lose that space with her, I lose so much.
So does trying to build some space outside of therapy where you can share yourself, would that work? It won't be the same, obviously, as they will be two way relationships, but it might help?
I am also very attached to her. It’s a weird thing with therapy, isn't it? That we are meant to build trust and relationship with them so that we share intimate stuff and the therapeutic relationship is supposed to be so crucial etc…but then, having built trust and relationship and intimacy, we’re then supposed to just turn the tap off and not be in relationship with them anymore.
I get this 💯>. So much. You know how attached I am to my T and I think we see that relationship in similar ways.
And just the thought of losing that space, that relationship, having her to talk to…it is a very upsetting thought that makes me quite teary.
Totally get this too. And feel the same.
Because, she basically just says that it is my choice ie if I choose to end therapy, that’s my choice and she will support me (she said she would be sad about that) But she also said that I don’t have to put myself under the pressure of making a binary decision…that it’s not just about deciding do I want to be having weekly therapy now, or do I want to now permanently stop. She said things can be much more flexible and fluid. That, we could also pause, and I can just set up a session whenever I want. And she said that, even if we don’t see each other, the relationship (and the therapeutic container) is still there and still intact. So, I could contact her any time (in weeks, months, longer) to set up a session.
This is exactly what my T says too (though my T has not said she would be sad! Ibwish she did!!). But my T says it doesn't need to be all or nothing. That it can be whatever I make it. Once a fortnight. Once a month. Every now and then. The options are whatever I think will work for me.
I didn't take that as a vague response but a "I am here for you". She did say that when it reduces it's not about the heavy stuff anymore. And that confused me. Would that mean I couldn't talk about trauma if it's fortnightly or less? So I asked her and what it meant for our relationship. As I also had in my head that the way I carry her around with me would change if therapy reduced. But she reassured me and said that she will remain the same therapist, which I took to mean she will provide the same care and attention at every single session, like she does now. So it's my mindset that needs the shift.

I have no idea when you know it's the right time. But also, reducing therapy doesn't mean you can't increase therapy again.

I personally think it will be a leap of faith. Previously I thought it would be like "graduating". That you would know when the time is. But now I think I know when the time isn't, as opposed to when it is. Because that attachment is so great. I don't know how you can reduce the attachment. I'm assuming it is reframing the attachment? Holding it and being secure in it. But I'm viewing that in the eyes of a reduction as opposed to stopping completely. I can't even go to the stopping completely because the loss of her is too much. So I am hoping with a reduction, that sense of loss will reduce and at some point a complete stopping will feel ok
 
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My therapists have always been super keen on the whole :

“Best possible thing will be to have the self confidence to quit therapy for a year, and go practice those skills out in the real world… and if in a month, or 6 months, or 10 years, or something gets hard -next week or in 20 years- and you want to come in for a couple weeks, or two years? No worries! I’m here to help you learn skill sets, to advise, be an ally. Sometimes you’ll need that, sometimes you won’t. Trusting yourself to swim on your own? Not. A. Bad. Thing. And? Come back whenever you need or want!!! I’d love to hear from you, if nothing else. This is your life. I’m honored to be a part of it, for a time, but at the end of the day? You go home to your life, and I go home to mine. We each have to make the best decisions, for ourselves.”

It’s been so oft repeated, by every therapist I’ve ever worked with? It’s like knowing by heart any other phrase/part of a relationship (Getting to knooooow you, etc.).
 
I think the reduction idea makes sense. Also my T even though she’s retired gets back to me right away when I need her and will talk to me on the phone to help me work through shit . It’s wayyy less frequent than sessions and not as long, but it sure is helpful to know she’s there.
 
I think we may have an inkling that it's time, but also need a little push to do it. I would probably still happily be doing trauma therapy and emdr twice a week if a situation hadn't arisen when I couldn't remain with my T. Finding a new one was hard, but when I did I realized that I had probably accomplished everything that I was going to in trauma therapy, at least for now.

I have so much respect for Ts who tell their clients that they've graduated.
 
I think I differ from most on here in that I don’t want to see a therapist. I did it because I was out of options. I have no interest in sort of throwing money out every week to talk to someone if it isn’t really going anywhere or making a measurable difference.

Can you look at it that if you stop, you’ve got the supports, it’s money you can save up to put towards a nice treat youve been wanting as a kind of goal. Worst comes to worst, you give it a shot for a bit and say hey, I wasn’t ready - can I come back.

Your T has obviously helped you a lot, but she’s a paid professional on your life. At some point in some way it’s a relationship with an ending.
 
I so hear your concerns and feelings regarding you ambivalence towards ending the therapeutic relationship. Leaving a relationship of 10 years isn't easy. She has gotten to know a huge chunk of your life, and it makes sense for you to have feelings of loss and grief regarding losing that kind of person in your life. AND, you clearly feel ready to move on because otherwise, you wouldn't make a post about it and discuss leaving. For example, I have no thoughts of leaving my therapist as of yet because I am clearly not ready yet and still have lots of work ahead with her. I feel happy with my progress and feel the flow in the therapy room. My guess is that your gut knows deep down you are ready, but the feelings of loss are blocking you from taking the step to end it. I wish you luck in this decision-making process.
 
Sometimes it's time to move on to a new T with a different skill set. Training is training but people tend to learn to value what works the best for their clients based on experience.
But like any really good doctor your T needs to learn more and stay up to date - which isn't easy now days. That commitment should extend to attending workshops, training sessions and more to keep up with whats new in their field.

For me, a change was as good as a rest. Moving on to a new T really helped me move forward again in the last year.
 
in my own early therapy, i was so prone to transference that therapists handed me off frequently for fear of playing into my attachment disorder. the many, many therapy sessions i had as a result covered many of the points you cover in your points above. our cases are not all that similar, but i find myself wondering if you should print out this letter and carry it with you to your next session.

whether you choose to do so, or not, i thank you for the review of my own therapy.
 
I'm planning to end my therapy next spring, and I think I'm ok with the decision. In my country (Finland) the decision is partly based on national health insurance, which offers co-pays for three years of therapy IF the patient is going back to work or is working. There is no chance to taper it off, either one goes weekly or not. I've been on disability for two years now and I don't want to make up a story about how I'm going back to work when I don't see it as realistic chance. I've had one year paid by insurance, two years out of pocket, and I don't think the insurance will allow me a second year.

With my therapist I feel I've talked about all my traumatic experiences already and got some excellent techniques to ground myself or stop flashbacks. I don't feel like I have anything new to bring to our sessions, and often I'm at loss at what to talk about. I like her and I trust her, but I don't feel I'm attached to her. I would notice she was missing from my weekly schedule, and I would miss having someone to talk to, but I feel like my therapy isn't going anywhere anymore. Last year it was different, I wasn't ready to end it then. I felt I needed her more.

My therapist is not eager to end our working relationship, she would prefer to continue with me, but I think it's partly because I'm a nice client who pays in time and doesn't skip sessions, and we've worked together long enough to get to know each other. When I was working in mental health, I preferred people I already knew. It was easier to plan what to do with them.

I have still few goals for therapy, DID parts work mostly, but my health PTSD-wise has been stabile for a long time now and even though the situation isn't good, I feel like I've gotten what I can get from this person and from trauma therapy. I'm looking forward to having more money, because even the co-payments stretch my budget more than I would like and having no money is one of my triggers.

I don't know if you get anything from my ramblings, but there was definite difference for me when I thought about ending therapy year ago compared to now. I felt very distressed thinking I wouldn't see my therapist anymore. Now it's more like "ok, then.", and I feel somewhat ready to be on my own. I don't have anyone else who would talk with me about these things, but I'm an avid journaler, and I hope it will be enough for me.
 
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