Should I stay or should I go. The Re-union Tour.

Packed Bags

This is a post I wrote almost two years ago.  I thought I would repost it because I had some things I wanted to add.  I will add them at the end.

All therapy comes to an end. The question is what to do when the therapy ends abruptly or the patient has been wanting to leave for a while. But what if it is the therapist who wants out of the relationship and does things unconsciously to get the patient to end the relationship? Like missing an appointment, double booking or even being hostile to a patient. It is always unconscious.  Therapist’s are people too. They have their own psychological wounds.  Sometimes a therapist will tell a patient they don’t need therapy anymore. I believe, it is always up to the patient to decide that.  If a patient seems to be coming less and less I might bring up the idea of working toward an ending. 

I think a proper termination is always the best way to end. However, it doesn’t always go that way. When patients leave abruptly and give a reason it is rarely the reason given.  They may blame it on parking, money or even “ not getting anything” out of therapy any longer.  Or because of schedules the therapy may evaporate. Either way, exploration for the departure is always best. Maybe the work was getting to deep.  Maybe my patient felt uncared for.  Maybe an addiction had resurfaced and she was too ashamed to bring it into session.

I have come to understand that patients leaving abruptly or starting with a new therapist before our work is completed can be from something unaddressed between the me and my patient.    The decision to leave can can arise out of their anger that the therapy isn’t bringing them the happiness they thought it would.  The patient will blame me most of the time. They might say something like “I have been doing this for a few years and I am not getting any better.” They usually say something to me  like “ you  are a nice person or I really like you, but I don’t think it is working” which translates to it being my fault. It is my fault in that something I said has made her feel like she can’t talk to me about her feelings. It is not up to me to “make them better.” It is up to me gently listen and hopefully we can repair our relationship. 

When I was neophyte psychotherapist,  I would have tried to convince my patient to stay. Now I know better. If she really wants to leave I will say OK.  I usually will leave the door open for her return.  

Moving doesn’t have to hurt. But sometimes it does.

The office has moved.  As I was leaving my assistant  asked me if I felt sad at all.  Surprisingly, I have no sad feelings about leaving my current office space.  She replied with ”that means this is the right move for you.”    She was right.  In the past when I have felt  angst about  major life change, I still knew it was the right decision for me.  So is this a function of maturity or was it the right time to move to a home office?  Or as I go through more changes they become less “big” for me? The space I have created to go to is very much the way I want it to be.  The colors are new  and fresh.    In the past I had to fight with landlords to give me new paint even when I would  agree to  a three year lease.  I usually got back, well then I will just have to charge you more rent.”  No, thank you!  So maybe for the first time the space is exactly as I want it.  

Sometimes we make decisions because we know it is best for us. It can still be excruciatingly painful. That doesn’t mean it is wrong. We must always look at why we let our lives go  down a path that in the end would hurt us so badly to move on from. It is my job to help my patient deal with the pain initially  and then  to help her see she was the one who led herself to this place.   It is easier for me to see when  I am sitting in the therapist chair. It has taken me a very long time,  much of my own therapy and looking at my own pain to understand this.  My job is really to be with my patient as she goes through the pain.  I am never really sure how it will go but that is ok. 

I am very excited about my new space and as soon as my teenager son wakes up from his 12 hour beauty rest he will help me post a picture of the new space.  For some reason I can’t get the picture upright. Thank goodness he had computer stuff in middle school.  He usually says, “mom, you just have to do this”  and in one felt swoop he makes it all better!