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Smittenkitten
Casual Contributor

Termination of long-term therapy - how do people cope?

Hi all,

 

I'm currently going through a termination process with my therapist of three years. In that time, we have grown very close, and I'm also currently at a phase in my life where I'm very isolated and lack anyone to really talk to other than her.

 

Unfortunately she is closing her practice, and I'm not at a stage where I can go on without further therapy. I have found a wonderful psychologist to work with, but it will take time to build rapport with her and I am very scared I won't be able to find a new psychiatrist to manage my medication (I am working on it, but it's a big source of stress for me).

 

I've never been through termination before, and I don't really know what I'm supposed to do. I would like to express my fondness for my therapist, but although I know that's appropriate, I am shy about telling people I care about how I feel, even if it's nice things!

 

I guess I'm hoping others have been through this before, and can give some advice about the best way to cope, especially considering that in three weeks I will have lost my only confidante. I struggle to meet people who understand me (as a queer, 30-something person with complex mental illness).

 

Hoping to hear some of your experiences,

 

Smittenkitten

14 REPLIES 14

Re: Termination of long-term therapy - how do people cope?

Hi @Smittenkitten ,

 

I've been through termination of long-term therapy.

 

Sometimes, it really sent me off the rails... other times, therapists worked very closely with me to minimise the pain of termination.

 

I'd like to say, how you transition through therapy termination has a lot to do with you. As much as i did not want therapy to end, I worked with my therapist to develop the mindset that end-of-therapy was an opportunity for celebration. The end of one journey is the beginning of a new one. Hence, it is about seeing the opportunities that come with the new journey, rather than dwelling on 'loss'.

 

With my weekly therapy sessions, I gradually reduced to fortnightly, then every 3 weeks, then a monthly check-in. This was planned in alignment with a discharge date. In the meantime, it was also about setting me up with other support networks and having that overlap time.

 

Dear @Smittenkitten , I know it is hard. It can be painful. Yet it can also be a celebration.

 

The ball is in your court. You can choose to focus on the 'end' or focus on the 'beginning' of your new journey.

 

Continue to reach out, including here, if you feel it helps.

 

All the best,

 

BPDSurvivor

Re: Termination of long-term therapy - how do people cope?

Hello @Smittenkitten 

 

It is natural to feel fond of someone you spend time with and have grown to trust.  It is natural for you to want it to continue.  Honour your feelings, but the reality of change comes up throughout life.  DOnt be too afraid.

 

I am posting an academic article about opportunities and risks ....

 

You may find a better therapist, you may find you dont need as much .... it can go many ways ... more informal supports may come into your life

.

Take Care of you

 

https://www.semanticscholar.org/paper/Transference-and-countertransference%3A-Opportunities-King-O%2... 

Re: Termination of long-term therapy - how do people cope?

Hi and welcome, @Smittenkitten  🙂

 

I'm wondering if you can write your therapist a Thank You card?  That way you can ponder your words and it might be easier to express yourself?

 

I'm also wondering if you can express verbally to your therapist how difficult you will find leaving, and ask her for strategies? (Sorry if you've done this already)

 

Also, she might be able to recommend psychiatrists to work with? 

 

Wishing you all the best. 

Re: Termination of long-term therapy - how do people cope?

Hi @BPDSurvivor 

 

I like the idea of focusing on the positives of the change. It is a little tricky for me to see them right now, as the termination was not a planned one, but I'm working on a list I can take into my last few appointments.

 

I've definitely been fixated on the loss, so the idea of a change of perspective is really helpful even if I'm going to have to get creative.

 

Thanks,

Smittenkitten

Re: Termination of long-term therapy - how do people cope?

Thank you @Appleblossom, this article looks interesting but I don't seem to be able to access more than the abstract.

 

I'm definitely hoping that I can be less reliant on therapy in future, but I am finding the transition very stressful at present. It's not just about loss, but change. I don't do well with uncertainty I suppose, and right now everything feels shaky. I am lucky to be well supported (medically), but my informal supports leave a lot to be desired, hence trying to talk to those who get it on these forums!

Re: Termination of long-term therapy - how do people cope?

Hello @NatureLover 

 

I'm definitely planning to write her a thank you card! I'm a writer, so I express myself much better in writing than I do verbally.

 

It's funny you should mention it though; last night I wrote a long letter to her that I'm going to read in my next session. I think it will be easier for me than trying to speak off the cuff.

 

She's definitely aware of how much I'm struggling, and has offered me some suggestions, but it's still not going to be easy. I'm not emotionally close to my family and don't really have any friends I can talk to about what I'm going through.

 

I'm going to work with my GP to get a referral for a new psychiatrist; while my current one is happy to write referrals there's been some issues with them being accepted by other clinics. I'm happy with this arrangement as it means I can focus on processing the termination in our few remaining sessions.

 

I will let you know how I go with the letter!

 

Thanks,

Smittenkitten

Re: Termination of long-term therapy - how do people cope?

Sorry its prob too tekkie to be that useful anyway. @Smittenkitten 

Here are some diagrams

 

Learning to think about the therapeutic alliance in different ways might help your transition. They are not in real life relationships.

 

Even writing here about it opens you up and might give you some relief from the intensity.  I have had many counselling experiences and studied a lot about it too.  I would not have survived without the insights and support, but it can also be complicated as can be seen by a lot of the stories on this forum.  Take care

 

Double-Edged Swords: Understanding Transference and Countertransference in  Non-analytic Therapy by Judith A. Schaeffer, Ph.D.

 

 

 

 

Transference and countertransference: Opportunities and risks as two  technical constructs migrate beyond their psychoanalytic homeland |  Semantic Scholar

Re: Termination of long-term therapy - how do people cope?

Thanks @Appleblossom I am a counselling student at uni so I'm familiar with the concept of transference.

 

While it may not be a "real life" relationship, it is still a shared experience between therapist and client which at times can be quite intense. I know for a fact my therapist has been sad about termination, because she told me.

 

I do think it's important to acknowledge that while the therapeutic alliance may be somewhat "artificial", it does also contain elements of genuine connection between therapist and client, without which it would be impossible to have a productive working relationship.

Re: Termination of long-term therapy - how do people cope?

Hey @Smittenkitten, you mentioned you're queer (me too!) and struggle to meet people who understand you. I'm not sure if you're aware but we have a LBGTIQA+ Social Space on the forums where you can connect with others in the community if you like 😊

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