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DF,
Its nice to know I am not alone in this fear, but even more comforting to hear that "sometimes, it works out" and T doesn't terminate.
I actually have two Ts and when I told T2 about my depression and despair, she didn't seem as freaked out about it as T1, so I do feel that I would at least have her to fall back on if T1 terminates me. Still, T1 has been my T off and on since 1992 and I cannot bear to lose her. I am truly regretting her know how bad things are for me. I feel like I've become a burden to her.
Its nice to know I am not alone in this fear, but even more comforting to hear that "sometimes, it works out" and T doesn't terminate.
I actually have two Ts and when I told T2 about my depression and despair, she didn't seem as freaked out about it as T1, so I do feel that I would at least have her to fall back on if T1 terminates me. Still, T1 has been my T off and on since 1992 and I cannot bear to lose her. I am truly regretting her know how bad things are for me. I feel like I've become a burden to her.
LG... this is a real bind. We need to tell our Ts how we are actually doing and we should be able to discuss anything. That sounds good in theory. Unfortunately, many Ts are not equipped to handle such openness. So many have lost Ts due to admission of transference/attachment, or in discussing how sad/hopeless they feel or because the T just got scared and bailed out on them.
The day my oldT first asked me if it would be difficult for me to lose him was the day I gathered ALL my courage and read an excerpt to him from my journal. There was nothing truly horrible in it (at least I thought so) but I talked about how I was not as happy as he thought I was and that it was hard for me to tell him when I was struggling because I didn't want him to be disappointed in me and so at times I would hide my feelings and act the way he wanted me to ... but it was an act and I was not strong enough to bring up whatever it was that was troubling me.
Well, I guess he didn't like hearing that and in my mind that journal excerpt is what made him decide to leave me. Of course it could be a combination of other things, like him deciding he didn't want to deal with me outside of session or that he was out of his depth or that he was too enmeshed in my emotional life. I have no idea, all I know is as soon as I read that to him he got up and said those words to me that were the beginning of the end for me. From that day throughout the six weeks of summer I hung on to the relationship with all that I had and he still abandoned me.
The legacy this leaves with me is that it is very dangerous to be fully open and honest with a T and to never allow anyone to really know all of you and once they do they will leave you. I am really struggling to get past this in my relationship with newT because I find myself unable to open up about myself, my past and my fears, believing that it will cause him to reject me.
The other thing my oldT did was anytime I even hinted that I was feeling down or sad or anxious about something he would go off on his soapbox about how I needed to be medicated blah blah when he knew how I felt about it. So I stopped telling him how I felt. I wanted to discuss my feelings and was trying to open up new dialogue and he was telling me I needed meds. We could never really get past that.
Thankfully newT had not suggested meds for me as I told him I'm opposed to it. I guess he is waiting to see if I can improve w/o them first.
So sorry for getting away from your situation...there may be very good reasons why you have not heard back from your T that have nothing to do with what you told her but I know that it's the longest ever wait between contacting them and getting a response. It's awful sitting there and wondering and trying not to let your imagination go crazy. Question... has she ever freaked out before when you have told her things? Is there any real reason why you would think she is freaked out about what you said?
I'm sorry you are sitting there waiting and I do hope you hear from her soon.
TN
The day my oldT first asked me if it would be difficult for me to lose him was the day I gathered ALL my courage and read an excerpt to him from my journal. There was nothing truly horrible in it (at least I thought so) but I talked about how I was not as happy as he thought I was and that it was hard for me to tell him when I was struggling because I didn't want him to be disappointed in me and so at times I would hide my feelings and act the way he wanted me to ... but it was an act and I was not strong enough to bring up whatever it was that was troubling me.
Well, I guess he didn't like hearing that and in my mind that journal excerpt is what made him decide to leave me. Of course it could be a combination of other things, like him deciding he didn't want to deal with me outside of session or that he was out of his depth or that he was too enmeshed in my emotional life. I have no idea, all I know is as soon as I read that to him he got up and said those words to me that were the beginning of the end for me. From that day throughout the six weeks of summer I hung on to the relationship with all that I had and he still abandoned me.
The legacy this leaves with me is that it is very dangerous to be fully open and honest with a T and to never allow anyone to really know all of you and once they do they will leave you. I am really struggling to get past this in my relationship with newT because I find myself unable to open up about myself, my past and my fears, believing that it will cause him to reject me.
The other thing my oldT did was anytime I even hinted that I was feeling down or sad or anxious about something he would go off on his soapbox about how I needed to be medicated blah blah when he knew how I felt about it. So I stopped telling him how I felt. I wanted to discuss my feelings and was trying to open up new dialogue and he was telling me I needed meds. We could never really get past that.
Thankfully newT had not suggested meds for me as I told him I'm opposed to it. I guess he is waiting to see if I can improve w/o them first.
So sorry for getting away from your situation...there may be very good reasons why you have not heard back from your T that have nothing to do with what you told her but I know that it's the longest ever wait between contacting them and getting a response. It's awful sitting there and wondering and trying not to let your imagination go crazy. Question... has she ever freaked out before when you have told her things? Is there any real reason why you would think she is freaked out about what you said?
I'm sorry you are sitting there waiting and I do hope you hear from her soon.
TN
Hi LG, I'm glad you made this thread and brought this stuff up! It's definitely good to talk about.
I thought about this a lot, and tried to think about what I could have said and done differently to make him not leave me. After doing an insane amount of research in the past few hours on ethical terminations my thoughts are now this: I don't think that it's in anyway wrong for a therapist to decide that they can no longer continue treatment because the therapy has moved into an area that they do not have experience in; in that situation it would be harmful and unethical on the therapists part to continue therapy despite feeling that they cannot be of help to the client. The part that could be unethical is how they decide to end therapy. Normally there would be a time called pretermination where the idea is introduced and discussed, then the client would have a period of time to mourn and grieve the loss of the therapeutic relationship while the therapist is there to be sensitive and understanding of these feelings, then the transfer to another therapist or program would be done if needed, then after all of that, the client and therapist decide together on a date for the final session. The ending result of termination should leave the client feeling confident and strong, and know that this transition is a positive step in their journey towards health. There should be no feelings of abandonment.
Being scared and withholding information in fear your therapist will terminate because they can’t handle you is unhelpful and damaging. I really don’t want to see anyone here fall into that because of the stories of unethical terminations that have been shared by me and other members. I think if there could be a positive outcome from hearing our stories for the other members it would be to discuss how termination will be handled right now. Ask your T’s thoughts on termination and if an appropriate amount of time would be allotted to grieve the relationship.
Having said all that, I’m very grateful that I didn’t withhold information in hopes of my T not leaving me, the only thing that’s now an issue is the unethical termination of being blind sighted, given no warning, and told in one session that we will never see each other again.
quote:Does anyone here ever feel afraid to tell their T just how sad you really are out of fear that they will terminate you because you are too much for them to handle?
I thought about this a lot, and tried to think about what I could have said and done differently to make him not leave me. After doing an insane amount of research in the past few hours on ethical terminations my thoughts are now this: I don't think that it's in anyway wrong for a therapist to decide that they can no longer continue treatment because the therapy has moved into an area that they do not have experience in; in that situation it would be harmful and unethical on the therapists part to continue therapy despite feeling that they cannot be of help to the client. The part that could be unethical is how they decide to end therapy. Normally there would be a time called pretermination where the idea is introduced and discussed, then the client would have a period of time to mourn and grieve the loss of the therapeutic relationship while the therapist is there to be sensitive and understanding of these feelings, then the transfer to another therapist or program would be done if needed, then after all of that, the client and therapist decide together on a date for the final session. The ending result of termination should leave the client feeling confident and strong, and know that this transition is a positive step in their journey towards health. There should be no feelings of abandonment.
Being scared and withholding information in fear your therapist will terminate because they can’t handle you is unhelpful and damaging. I really don’t want to see anyone here fall into that because of the stories of unethical terminations that have been shared by me and other members. I think if there could be a positive outcome from hearing our stories for the other members it would be to discuss how termination will be handled right now. Ask your T’s thoughts on termination and if an appropriate amount of time would be allotted to grieve the relationship.
Having said all that, I’m very grateful that I didn’t withhold information in hopes of my T not leaving me, the only thing that’s now an issue is the unethical termination of being blind sighted, given no warning, and told in one session that we will never see each other again.
**Trigger - imagining the other side**
You know, I think the flip side of this problem is worth considering: what is the ethical obligation of the therapist who comes to believe, looking at all the evidence in front of her or him, that their work with a client is either harming the client or simply not creating progress for that client?
If you imagine yourself into that position, what do you think you would do? Imagine you have tried out all the directions, skills, techniques that you have to hand, and you realise at some point that you simply don't know how to help. You don't believe this is the client's fault - you are aware that every therapist has a different approach, different skills, and perhaps more importantly a different 'vibe', so you're a long way from seeing the client's situation as hopeless, but you think something about your approach or the dynamic between you is really holding the client back, and you can't see any way of rectifying that. What should you do?
Let me be really clear that I am not saying anyone's T SHOULD have terminated them, and I believe many of the terminations people have written about here have been extremely badly handled. I am sorry if it's triggering to imagine this.
But I also think it is a really valuable thought experiment, and if you can handle thinking it through, it might offer some insights about termination in general, why it crops up and *why* it is so often badly handled.
How would you handle it, if you were the T? Especially given what you know about how the client is likely to react?
Jones
You know, I think the flip side of this problem is worth considering: what is the ethical obligation of the therapist who comes to believe, looking at all the evidence in front of her or him, that their work with a client is either harming the client or simply not creating progress for that client?
If you imagine yourself into that position, what do you think you would do? Imagine you have tried out all the directions, skills, techniques that you have to hand, and you realise at some point that you simply don't know how to help. You don't believe this is the client's fault - you are aware that every therapist has a different approach, different skills, and perhaps more importantly a different 'vibe', so you're a long way from seeing the client's situation as hopeless, but you think something about your approach or the dynamic between you is really holding the client back, and you can't see any way of rectifying that. What should you do?
Let me be really clear that I am not saying anyone's T SHOULD have terminated them, and I believe many of the terminations people have written about here have been extremely badly handled. I am sorry if it's triggering to imagine this.
But I also think it is a really valuable thought experiment, and if you can handle thinking it through, it might offer some insights about termination in general, why it crops up and *why* it is so often badly handled.
How would you handle it, if you were the T? Especially given what you know about how the client is likely to react?
Jones
TN,
I can't believe that your previous T terminated you after sharing your journal. I am sooooo glad you are not going to that T anymore. You deserve a better T...someone who will be there when you need them the most.
No, T1 has never freaked out on me before when I've told her things. She's always been there for me. I guess the reason I was worried that I freaked her out today was because after we set up an appointment for next week, she said that she would like to set up an appointment for tomorrow too and that she would feel much better about things if we were talking more frequently. After my session I got to thinking about some of the things she said and I realized she is worried about my safety, and then I felt really bad because the LAST thing I want is to be a burden to her.
I guess tomorrow I can bring this fear of termination up with her and explain that I feel like I walk a fine line between needing to tell her what is really going on for me and not wanting to freak her out and risk losing her.
She just texted me back and said, "I won't worry. You are VERY resilient. Talk to you tomorrow".
I can't believe that your previous T terminated you after sharing your journal. I am sooooo glad you are not going to that T anymore. You deserve a better T...someone who will be there when you need them the most.
No, T1 has never freaked out on me before when I've told her things. She's always been there for me. I guess the reason I was worried that I freaked her out today was because after we set up an appointment for next week, she said that she would like to set up an appointment for tomorrow too and that she would feel much better about things if we were talking more frequently. After my session I got to thinking about some of the things she said and I realized she is worried about my safety, and then I felt really bad because the LAST thing I want is to be a burden to her.
I guess tomorrow I can bring this fear of termination up with her and explain that I feel like I walk a fine line between needing to tell her what is really going on for me and not wanting to freak her out and risk losing her.
She just texted me back and said, "I won't worry. You are VERY resilient. Talk to you tomorrow".
Jones-
Exactly, I totally agree, and I *think* that was what my therapist was trying to say when he just kept repeating "I am not the right therapist for you". Like I said in my post above, and I know you were saying too, is that the issue is how the therapist handles the termination, not deciding to terminate because they can no longer help the client.
quote:You know, I think the flip side of this problem is worth considering: what is the ethical obligation of the therapist who comes to believe, looking at all the evidence in front of her or him, that their work with a client is either harming the client or simply not creating progress for that client?
Exactly, I totally agree, and I *think* that was what my therapist was trying to say when he just kept repeating "I am not the right therapist for you". Like I said in my post above, and I know you were saying too, is that the issue is how the therapist handles the termination, not deciding to terminate because they can no longer help the client.
Hi LG,
I fear the same thing. My T has really been so compassionate and understanding with me that I pretty much know she wouldn't terminate me. Yet, I still *feel* like she will. I'm always at either a completely numb place or a bad place or a horrible place, and I'm waiting for the day when my T gives up on me or blames everything on me. I hesitate and do hold back some things because I don't want that to happen. But, several times, I've told her about having suicidal thoughts and explained how close I was once. Each time I have those thoughts and I know I *should* tell T, I'm afraid to because I imagine her thinking, oh, THIS again? She's only ever been compassionate and always tries to understand what I'm feeling and helps me figure out ways to get through the rough spot. We've been working together for nearly 9 months, and she's really got a flawless track record (as she would refer to it!), although I know that can always change - and I'm sure it will eventually. I just fear she'll give up, especially because I know I would have given up on me already.
That probably wasn't very helpful - sorry, LG. But I do want to say that, of course, the one and only time I've called my T for anything other than scheduling, she didn't hear her phone. She called me back first thing the next morning and apologized, saying she didn't know why she hadn't seen that I'd left a voicemail. Of course, I had convinced myself that I should never have contacted her and really regretted it at the time (and still kind of do, but not because of anything my T did). But she *did* call back - I don't know if that is the situation with your T, but I just want to throw that out there.
Big hugs to you, LG.
I fear the same thing. My T has really been so compassionate and understanding with me that I pretty much know she wouldn't terminate me. Yet, I still *feel* like she will. I'm always at either a completely numb place or a bad place or a horrible place, and I'm waiting for the day when my T gives up on me or blames everything on me. I hesitate and do hold back some things because I don't want that to happen. But, several times, I've told her about having suicidal thoughts and explained how close I was once. Each time I have those thoughts and I know I *should* tell T, I'm afraid to because I imagine her thinking, oh, THIS again? She's only ever been compassionate and always tries to understand what I'm feeling and helps me figure out ways to get through the rough spot. We've been working together for nearly 9 months, and she's really got a flawless track record (as she would refer to it!), although I know that can always change - and I'm sure it will eventually. I just fear she'll give up, especially because I know I would have given up on me already.
That probably wasn't very helpful - sorry, LG. But I do want to say that, of course, the one and only time I've called my T for anything other than scheduling, she didn't hear her phone. She called me back first thing the next morning and apologized, saying she didn't know why she hadn't seen that I'd left a voicemail. Of course, I had convinced myself that I should never have contacted her and really regretted it at the time (and still kind of do, but not because of anything my T did). But she *did* call back - I don't know if that is the situation with your T, but I just want to throw that out there.
Big hugs to you, LG.
Hi Mac - we cross posted - and yep, you answered my questions before I asked them!
But I also want to acknowledge what an incredibly high bar this is for both client and therapist:
Many of us here feel feelings of panic even considering termination at some point in the abstract. How many would be able to work through to that place of transition as a positive step, once the T had indicated therapy would end?
I am *not* in any way laying blame with the clients. I am saying maybe this situation is just inherently, structurally more fraught and difficult to handle than we can be aware of as clients.
J
But I also want to acknowledge what an incredibly high bar this is for both client and therapist:
quote:Normally there would be a time called pretermination where the idea is introduced and discussed, then the client would have a period of time to mourn and grieve the loss of the therapeutic relationship while the therapist is there to be sensitive and understanding of these feelings, then the transfer to another therapist or program would be done if needed, then after all of that, the client and therapist decide together on a date for the final session. The ending result of termination should leave the client feeling confident and strong, and know that this transition is a positive step in their journey towards health. There should be no feelings of abandonment.
Many of us here feel feelings of panic even considering termination at some point in the abstract. How many would be able to work through to that place of transition as a positive step, once the T had indicated therapy would end?
I am *not* in any way laying blame with the clients. I am saying maybe this situation is just inherently, structurally more fraught and difficult to handle than we can be aware of as clients.
J
quote:After my session I got to thinking about some of the things she said and I realized she is worried about my safety, and then I felt really bad because the LAST thing I want is to be a burden to her.
LG, I think you need to bring this up with your T tomorrow. It is your therapy, and you should not have to look after your T's needs. Just try and let her know that you were feeling this way.
Jones-
I’m kind of confused here- I mean, the end of the therapeutic relationship is inevitable, since it is a professional relationship that has a start and an end.
True, and I wasn’t saying that it was easy- hence the time needed to be angry, feel abandoned or scared initially, but then work though those feelings and grieve and all that.
quote:How many would be able to work through to that place of transition as a positive step, once the T had indicated therapy would end?
I’m kind of confused here- I mean, the end of the therapeutic relationship is inevitable, since it is a professional relationship that has a start and an end.
quote:I am saying maybe this situation is just inherently, structurally more fraught and difficult to handle than we can be aware of as clients.
True, and I wasn’t saying that it was easy- hence the time needed to be angry, feel abandoned or scared initially, but then work though those feelings and grieve and all that.
quote:You know, I think the flip side of this problem is worth considering: what is the ethical obligation of the therapist who comes to believe, looking at all the evidence in front of her or him, that their work with a client is either harming the client or simply not creating progress for that client?
Jones, this is a dilemma but did not apply in my case. I WAS making good progress and in fact just a month before my abandonment, my T emailed me noting that I am making significant progress in my therapy. Huh? That's a good thing right? Then I'm told I need a trauma T because he cannot help me. It IS ethical for a T to terminate a client when the client is not making progress or being harmed. Neither applied to my situation. They are also first supposed to seek supervision or consultation and document the steps they have taken to help the client. It is also very odd to decide 3 years into the therapy that you are not a good enough T for the client. As newT says... the T does not just get to walk away at that point. That is the absolute last resort after all other options are exhausted.
Then yes, termination is a "process" and it's recommended to have 3 sessions for each year of therapy to transition the client to a new T and to work through the grief and loss.
Also in my case, I had no issues with the therapy itself, only with the manner of termination which constituted abandonment and harm to the client which is unethical and violates the rules of the APA.
As for discussing termination before it happens.... I did that. We discussed it numerous times and he always reassued me that I would be the one to decide when I leave him and that he would not ask me to leave and that his door would always be open to me if I did leave and I could return at any time. I even asked him point blank 5 weeks before he abandoned me if he was trying to terminate me and he said "no, not at all".
I do see that termination is an area fraught with issues and fears on both sides but most Ts have NO idea how to handle it ethically and compassionately and the profession has failed in educating T's and P's in this area.
Mac, I have also done EXTENSIVE research on termnations and there is barely anything written about T's who abandon/blindside their patients. Most "forced" terminations discuss the ending of therapy due to death of T or relocation or of interns who are made to move on in their training. NewT says of course I would not find anything as in those cases it's always the patient's fault (in the eyes of the T) and does not bear examination. The profession sweeps these things under the rug.
All of this does give me a great topic for my Master's thesis!
LG.......so glad you heard from your T. Sounds like she has a lot of faith in you.
TN
quote:It IS ethical for a T to terminate a client when the client is not making progress or being harmed.
Those are two examples, and another ethical reason to terminate is that the T feels that he does not have the skills to help the client, and that client would be better helped by someone else. I’m just saying this because I saw that this was a reason on the American Counseling Association website. I totally agree that its VERY WEIRD to decide 3 years (or in my case 18 months) into therapy to SUDDENLY decide that you can’t help this client. It’s so mindboggling. I think about my session last week, and how he said so many things about he sees me for who I really am, and that I am worth so much and all this stuff… and then the VERY NEXT WEEK he somehow decides that he’s not the right therapist for me. WHAT THE HELL WAS THAT?!?!?!?
quote:Mac, I have also done EXTENSIVE research on termnations and there is barely anything written about T's who abandon/blindside their patients. Most "forced" terminations discuss the ending of therapy due to death of T or relocation or of interns who are made to move on in their training.
I KNOW! It’s so frustrating. I feel like I’m having to put together little bits and pieces from different websites to try and get an idea about what abandonment actually means. I wish there was some concrete information. Mainly I’ve been finding situations where the therapist is moving or died or something, just like you said. So basically I’ve just gone off of my findings on what appropriate termination is, and then compared it to mine, and realized that mine was abandonment, not appropriate termination.
quote:quote:
How many would be able to work through to that place of transition as a positive step, once the T had indicated therapy would end?
I’m kind of confused here- I mean, the end of the therapeutic relationship is inevitable, since it is a professional relationship that has a start and an end.
Sure - I mean once the T had indicated therapy would end before the predicted course of treatment had finished, so to speak - before the client has expected.
quote:True, and I wasn’t saying that it was easy- hence the time needed to be angry, feel abandoned or scared initially, but then work though those feelings and grieve and all that.
Yes yes yes - absolutely. We are on the same page here.
TN, agreed on everything you say about your termination experience, and particularly about this:
quote:I do see that termination is an area fraught with issues and fears on both sides but most Ts have NO idea how to handle it ethically and compassionately and the profession has failed in educating T's and P's in this area.
If you can bear with me being the devil's advocate on this, though, I just want to consider *why* it's such a blind spot for the profession. I think there *is* an expectation that a good T will be able to contain the process and get both parties through without harm, without feelings of abandonment. And I actually don't know if it's possible. How is a client supposed to handle any kind of termination, no matter how well managed, if the client is not developmentally ready to work through their abandonment stuff?
I have been through three relatively well-managed terminations in a couple of years, now, two my call and one not. Because none of the therapies was completed, they each have touched my abandonment stuff. And I know they have touched the T's abandonment stuff too, because I have watched them freaking out. One came in looking kinda harrowed as we got towards the end, and told me she was feeling really triggered about recreating a 'bad mother' experience for me. She was a pretty good T but she 'went wobbly' as termination came close, and it seemed to me she was right at her limits with it. It made things considerably more painful for me.
I think you, Mac and many others have every right to be extremely angry about the botch-ups your Ts have made, and I am angry with you. LG was considering the pattern of T's botching up, and it just makes me wonder if we see this because good termination is kind of like advanced brain surgery in terms of the skill it requires. It seems like basic consideration to us to do it ethically - but I suspect it's harder than it looks.
J
I think that perhaps one of the biggest reasons proper preparation for terminating therapy is so often really rocky or downright horrible is because of how deep the therapeutic relationship can get. If I can take your experience, Jones, as an example - your T was triggered by her own stuff which is very unique. The termination could have followed every guideline recommended in that situation, but strong emotions are very hard things to contend with. I think I've rambled and not really made my point...but, in short, it seems like the depth of the relationship and the threat that termination poses is related to these horrible experiences. Not that it excuses their behavior, but I'm just saying it's probably an element.
I think one shot terminations are unethical unless the therapist has been told they are damaging the client terribly by every continued moment.
I also think a book needs to be written on attachment in therapy including a couple of chapters on this kind of unethical termination and the fall out the client experiences.
My ex C terminated with me because I made her angry and she acted out her fury.
Not a good enough reason.
I too am left terrified that sweet P will terminate with me suddenly - becos of this thread I shall bring up my fears AGAIN of this tomorrow when I see him. I just don't want to put my heart through that again right now.
It should be easier to complain about them too.
I want to put in a complaint about my ex C but she will have covered her back really well and painted me as the problem client - which is what they all can hide behind as TN knows too - so frustrating.
Sorry - off to work but will try and think about it all - and maybe post at the end of the day.
I also think a book needs to be written on attachment in therapy including a couple of chapters on this kind of unethical termination and the fall out the client experiences.
My ex C terminated with me because I made her angry and she acted out her fury.
Not a good enough reason.
I too am left terrified that sweet P will terminate with me suddenly - becos of this thread I shall bring up my fears AGAIN of this tomorrow when I see him. I just don't want to put my heart through that again right now.
It should be easier to complain about them too.
I want to put in a complaint about my ex C but she will have covered her back really well and painted me as the problem client - which is what they all can hide behind as TN knows too - so frustrating.
Sorry - off to work but will try and think about it all - and maybe post at the end of the day.
Beautifully said, BG.
LG, I'm really glad you heard back from your T and in such a reassuring manner. There is nothing worse than that horrible time between contacting a T and waiting to hear back from them. I tended to populate it with all kinds of horrible thoughts and feelings on my Ts part (which never turned out to be true mind you, but still happened every time. 
) And the fear of abandonment was a constant thread throughout our work together and something we discussed on many occasions.
I probably come at termination a little differently because unlike the horrible terminations that many here have experienced, I've actually been blessed enough to have two good terminations. The first was because my first T retired and so was "forced" on me so to speak, while I made the decision to terminate with my second T because I believed our work together was complete (at least for the time being). So I've spent a lot of time thinking about it.
Jones, I really think you were on to something by identifying how difficult termination is not only for the patient, but also for the therapist. I think what makes termination SO very difficult is that it goes straight to the heart of the human condition. How do we live knowing we will eventually die? We all know that everyone eventually dies, but it's a topic that humans spend a lot of time avoiding facing or accepting. So, as in other areas, therapy serves as a microcosm for life with the intensity turned way up.
If you think about it, any relationship we have is going to end. Eventually one of the people in it will die. Yet we chose to engage in relationships. Therapy and especially ending it, forces us to come face to face with this very painful fact. Why would we choose to invest do deeply in a relationship, to open up, to become vulnerable, to allow it to mean so much to us, knowing it will end? Fighting through this question is in some ways at the heart of therapy and of life.
One of the things that was so scary about opening up with my T and moving closer was that all of my experience with significant figures in my life taught me that moving closer only got me hurt. So there was a very strong voice in my head (it was actually a split off part of myself I had to integrate at one point during the work I did in therapy) which basically kept shouting at me "are you nuts? you're going to get hurt! How stupid can you be?" I actually remember dealing with a lot of anger towards my T for being so nice. I told him a number of times that I wanted to scream at him to stop being so nice, he was only making it harder and more painful because I knew it was going to end.
I do believe you should be able to take any and all of your feelings to your therapist, knowing that you will not be punished or sent away for expressing them. It is highly unfortunate that not all Ts can bear to hear all of a patient's feelings. My T made two things very clear to me and behaved in a very consistent manner around them. The first was that all of my feelings, no matter what they were, were welcome in his office and ok to express. He proved this by always be calm and accepting and affirming about any and all feelings that I expressed ranging from joy to anger to desire. That's what finally allowed me to believe I was actually acceptable. It's why I went to therapy. My deepest fear about letting someone get close was the absolute belief that once they got to know me well enough they would leave. So the whole point with my therapist was to let him see EVERYTHING, to completely know me, and see if he stayed. It's what helped me to get it all out. I remember early on the complete and absolute terror I felt going to tell my T about googling him and finding his grandaughter's blog which provided a lot of info about his family. I felt terribly guilty, and even worse, that having knowledge he didn't know about was setting up a power struggle I didn't want to engage in. So I went into a session and told him about it, expressing how I felt I had violated him, really crossed a line and I was terrified I would be sent away and we wouldn't be able to work together anymore. His reply was a very gentle "and yet you came to me and told me." He told me very clearly that he did not feel violated, that he really understood the desire to know him better, how difficult the boundaries in therapy could be, and that he was really glad I was willing to tell him. At one point, he asked me why I had decided to tell him, and my response was that the whole point was to see if he would stay and if I held back important information then I would just be doing with him what I did with everyone else which was holding back on all that I was from the fear of driving them away. I was very, very blessed in that my T was a strong enough, compassionate enough man to stay through all the pain, grief, anger and despair that I needed to express.
It takes a special kind of person to be able to stay through another persons pain and not draw away. It's a normal, healthy instinct in a human being to avoid pain. So it takes a conscious decision to stay in pain when its necessary, as well as choosing to stay with someone in pain. And when you are working with people like most of us on the forum who have some deep unresolved grief, it can take a lot of strength and commitment to face the pain. I believe it takes a lot of courage on the part of both the therapist and the patient to walk their together. And it's something that has to be learned by the therapist. Now don't get me wrong, they have chosen to do this work, which makes them responsible to do their own work to be capable of doing it, but I also have compassion that they are human and have struggles and blind spots like the rest of us. They just don't have the luxury of staying in denial, because they need to be there for their patients, even if it's a difficult place to go.
Hence the even worse difficulty of termination because it brings us face to face with issues about our own death, how we choose to live our life, how do we survive and even thrive in the face of the inevitable losses of life? For people with attachment injuries and severe fears of abandonment, I think the process can be even more intense. If a therapist is not prepared for the depth of where this will take them, I can understand being overwhelmed by it.
My first therapist's termination didn't exactly come at a good time. In January of the year she retired, my MIL went into the hospital for three weeks and at one point we were told she was going to die. She finally returned home after three weeks in the hospital. We went on vacation very shortly afterwards, and the day we returned we got a phone call that a very close friend of mine, a second mother to my children, had died quite suddenly of a heart attack. A week after we had gotten through the funeral (and some other difficulties surrounding her death including the fact that her husband was involved with another woman whom he took out the day after the funeral while I watched his children. OK not going there, still get furious!) my sister called to tell me that my mother had been diagnosed with lymphoma and was starting chemotherapy treatments (she is completely recovered and doing well now). Then a couple of weeks later, my FIL, who lived in a nursing home nearby, died from advanced Alzheimer's. The only word I can use to describe how I was doing was reeling. I was looking over my shoulder, looking to see from what direction the blow would come. FirstT had been instrumental in helping me get through all of it. So to say it was difficult for her to tell me she was retiring was an understatement.
She had decided to leave her clinical practice to return to school full time as she felt like she was being led to do other things. It had obviously been a very difficult decision for her. When she told me she was retiring (with around five months notice, she did it right) I tried to stay calm, but it was impossible. I literally started sobbing before she was halfway through the sentence and when I looked at her she had tears in her eyes. In some ways, we spent the rest of her time together trying to make it easier for each other. We were both aware that this was difficult for the other one. I kept thinking about the fact that I was dealing with losing only one person while she was losing ALL her patients. She did an excellent job of keeping things focused on my feelings and not hers, but I definitely held back at times because I was worried about her, especially about being angry with her. On some levels, although I knew her decision was about her life and had nothing to do with me, emotionally it felt like she was choosing to leave me knowing how it would hurt me. But to face that anger would be to acknowledge the depth of the loss and I think I could only do so much of that before shying away. Even with that, we had plenty of time to talk about the ending, what it meant, and what our work together had meant. It was difficult but ended up being very affirming.
My termination with my current T (the door is still open and I consider it highly probable that I will return at some point) was a long and difficult one but I am very grateful at how fully we faced it. But it took me a full year and more to work through leaving. There were so many intense feelings stirred up by ending the relationship that it took that long to process all of it. I think the thing I was the most grateful to my therapist for was that he just kept telling me this was like all our other work. We just needed to look at the feelings coming up. He also really normalized just why this would be so difficult for someone with my background. Our work really took off in the beginning after he told me that he would never ask me to leave (with apologies to TN, my T was actually able to carry through on that promise), that I was welcome to come as long as I wanted to. I made emergency calls to him to ask if it was still really up to me. I made emergency calls because the terror and grief that welled up at the thought of saying goodbye to him could often threaten to overwhelm me. Throughout the process my remained what he has always been, steady, unafraid and completely open to whatever I brought to him. I think the most important thing was his complete understanding and acceptance of just how important he was to me. He didn't shy away from that responsibility which is what allowed me to get through it. It was long hard work but being able to face an ending of such an important relationship while being free to examine everything and anything it evoked was SO important.
What I am most grateful for was that the ending was completely embraced by both of us (ok, still kind of a work in progress for me). There was a real celebration of what the relationship had meant to both of us, how it had changed us, and just how deep and real it was. and then facing that losing that was incredibly painful and threatening for me. But on the other side of the pain were some very important lessons. I know now that I can face deep grief and survive it and even thrive. I know that what my T taught me is part of me in a way I cannot lose. I learned that the pain was worth it because I carry him and the relationship and how it changed me in a way I CANNOT lose.
I'm sorry this had gone on for so very long, I am very much still in the midst of dealing with the termination. But I must say that I am so grateful that I had a T willing to face the deep issues and pain surrounding such a significant leavetaking and was strong enough to stay and hear all that I felt. I know I did the right thing because there were feelings and issues that I would never have faced if I hadn't left. But I won't lie, it was one of the most difficult things I ever did. But it also is what defined what we did together, that completed it, that gave it meaning. I miss him terribly but have no doubt that he is still there. I think what I'm really trying to say is that in therapy, as in life, we all face inevitable pain, but it is in our connections, in forming deep relationships that help us face our pain that we find meaning and purpose. I'm going to experience pain no matter what, but at least this way it means something.
AG
PS BG, we cross posted, I just want to say I really agree with what you said.
) And the fear of abandonment was a constant thread throughout our work together and something we discussed on many occasions. I probably come at termination a little differently because unlike the horrible terminations that many here have experienced, I've actually been blessed enough to have two good terminations. The first was because my first T retired and so was "forced" on me so to speak, while I made the decision to terminate with my second T because I believed our work together was complete (at least for the time being). So I've spent a lot of time thinking about it.
Jones, I really think you were on to something by identifying how difficult termination is not only for the patient, but also for the therapist. I think what makes termination SO very difficult is that it goes straight to the heart of the human condition. How do we live knowing we will eventually die? We all know that everyone eventually dies, but it's a topic that humans spend a lot of time avoiding facing or accepting. So, as in other areas, therapy serves as a microcosm for life with the intensity turned way up.
If you think about it, any relationship we have is going to end. Eventually one of the people in it will die. Yet we chose to engage in relationships. Therapy and especially ending it, forces us to come face to face with this very painful fact. Why would we choose to invest do deeply in a relationship, to open up, to become vulnerable, to allow it to mean so much to us, knowing it will end? Fighting through this question is in some ways at the heart of therapy and of life.
One of the things that was so scary about opening up with my T and moving closer was that all of my experience with significant figures in my life taught me that moving closer only got me hurt. So there was a very strong voice in my head (it was actually a split off part of myself I had to integrate at one point during the work I did in therapy) which basically kept shouting at me "are you nuts? you're going to get hurt! How stupid can you be?" I actually remember dealing with a lot of anger towards my T for being so nice. I told him a number of times that I wanted to scream at him to stop being so nice, he was only making it harder and more painful because I knew it was going to end.
I do believe you should be able to take any and all of your feelings to your therapist, knowing that you will not be punished or sent away for expressing them. It is highly unfortunate that not all Ts can bear to hear all of a patient's feelings. My T made two things very clear to me and behaved in a very consistent manner around them. The first was that all of my feelings, no matter what they were, were welcome in his office and ok to express. He proved this by always be calm and accepting and affirming about any and all feelings that I expressed ranging from joy to anger to desire. That's what finally allowed me to believe I was actually acceptable. It's why I went to therapy. My deepest fear about letting someone get close was the absolute belief that once they got to know me well enough they would leave. So the whole point with my therapist was to let him see EVERYTHING, to completely know me, and see if he stayed. It's what helped me to get it all out. I remember early on the complete and absolute terror I felt going to tell my T about googling him and finding his grandaughter's blog which provided a lot of info about his family. I felt terribly guilty, and even worse, that having knowledge he didn't know about was setting up a power struggle I didn't want to engage in. So I went into a session and told him about it, expressing how I felt I had violated him, really crossed a line and I was terrified I would be sent away and we wouldn't be able to work together anymore. His reply was a very gentle "and yet you came to me and told me." He told me very clearly that he did not feel violated, that he really understood the desire to know him better, how difficult the boundaries in therapy could be, and that he was really glad I was willing to tell him. At one point, he asked me why I had decided to tell him, and my response was that the whole point was to see if he would stay and if I held back important information then I would just be doing with him what I did with everyone else which was holding back on all that I was from the fear of driving them away. I was very, very blessed in that my T was a strong enough, compassionate enough man to stay through all the pain, grief, anger and despair that I needed to express.
It takes a special kind of person to be able to stay through another persons pain and not draw away. It's a normal, healthy instinct in a human being to avoid pain. So it takes a conscious decision to stay in pain when its necessary, as well as choosing to stay with someone in pain. And when you are working with people like most of us on the forum who have some deep unresolved grief, it can take a lot of strength and commitment to face the pain. I believe it takes a lot of courage on the part of both the therapist and the patient to walk their together. And it's something that has to be learned by the therapist. Now don't get me wrong, they have chosen to do this work, which makes them responsible to do their own work to be capable of doing it, but I also have compassion that they are human and have struggles and blind spots like the rest of us. They just don't have the luxury of staying in denial, because they need to be there for their patients, even if it's a difficult place to go.
Hence the even worse difficulty of termination because it brings us face to face with issues about our own death, how we choose to live our life, how do we survive and even thrive in the face of the inevitable losses of life? For people with attachment injuries and severe fears of abandonment, I think the process can be even more intense. If a therapist is not prepared for the depth of where this will take them, I can understand being overwhelmed by it.
My first therapist's termination didn't exactly come at a good time. In January of the year she retired, my MIL went into the hospital for three weeks and at one point we were told she was going to die. She finally returned home after three weeks in the hospital. We went on vacation very shortly afterwards, and the day we returned we got a phone call that a very close friend of mine, a second mother to my children, had died quite suddenly of a heart attack. A week after we had gotten through the funeral (and some other difficulties surrounding her death including the fact that her husband was involved with another woman whom he took out the day after the funeral while I watched his children. OK not going there, still get furious!) my sister called to tell me that my mother had been diagnosed with lymphoma and was starting chemotherapy treatments (she is completely recovered and doing well now). Then a couple of weeks later, my FIL, who lived in a nursing home nearby, died from advanced Alzheimer's. The only word I can use to describe how I was doing was reeling. I was looking over my shoulder, looking to see from what direction the blow would come. FirstT had been instrumental in helping me get through all of it. So to say it was difficult for her to tell me she was retiring was an understatement.
She had decided to leave her clinical practice to return to school full time as she felt like she was being led to do other things. It had obviously been a very difficult decision for her. When she told me she was retiring (with around five months notice, she did it right) I tried to stay calm, but it was impossible. I literally started sobbing before she was halfway through the sentence and when I looked at her she had tears in her eyes. In some ways, we spent the rest of her time together trying to make it easier for each other. We were both aware that this was difficult for the other one. I kept thinking about the fact that I was dealing with losing only one person while she was losing ALL her patients. She did an excellent job of keeping things focused on my feelings and not hers, but I definitely held back at times because I was worried about her, especially about being angry with her. On some levels, although I knew her decision was about her life and had nothing to do with me, emotionally it felt like she was choosing to leave me knowing how it would hurt me. But to face that anger would be to acknowledge the depth of the loss and I think I could only do so much of that before shying away. Even with that, we had plenty of time to talk about the ending, what it meant, and what our work together had meant. It was difficult but ended up being very affirming.
My termination with my current T (the door is still open and I consider it highly probable that I will return at some point) was a long and difficult one but I am very grateful at how fully we faced it. But it took me a full year and more to work through leaving. There were so many intense feelings stirred up by ending the relationship that it took that long to process all of it. I think the thing I was the most grateful to my therapist for was that he just kept telling me this was like all our other work. We just needed to look at the feelings coming up. He also really normalized just why this would be so difficult for someone with my background. Our work really took off in the beginning after he told me that he would never ask me to leave (with apologies to TN, my T was actually able to carry through on that promise), that I was welcome to come as long as I wanted to. I made emergency calls to him to ask if it was still really up to me. I made emergency calls because the terror and grief that welled up at the thought of saying goodbye to him could often threaten to overwhelm me. Throughout the process my remained what he has always been, steady, unafraid and completely open to whatever I brought to him. I think the most important thing was his complete understanding and acceptance of just how important he was to me. He didn't shy away from that responsibility which is what allowed me to get through it. It was long hard work but being able to face an ending of such an important relationship while being free to examine everything and anything it evoked was SO important.
What I am most grateful for was that the ending was completely embraced by both of us (ok, still kind of a work in progress for me). There was a real celebration of what the relationship had meant to both of us, how it had changed us, and just how deep and real it was. and then facing that losing that was incredibly painful and threatening for me. But on the other side of the pain were some very important lessons. I know now that I can face deep grief and survive it and even thrive. I know that what my T taught me is part of me in a way I cannot lose. I learned that the pain was worth it because I carry him and the relationship and how it changed me in a way I CANNOT lose.
I'm sorry this had gone on for so very long, I am very much still in the midst of dealing with the termination. But I must say that I am so grateful that I had a T willing to face the deep issues and pain surrounding such a significant leavetaking and was strong enough to stay and hear all that I felt. I know I did the right thing because there were feelings and issues that I would never have faced if I hadn't left. But I won't lie, it was one of the most difficult things I ever did. But it also is what defined what we did together, that completed it, that gave it meaning. I miss him terribly but have no doubt that he is still there. I think what I'm really trying to say is that in therapy, as in life, we all face inevitable pain, but it is in our connections, in forming deep relationships that help us face our pain that we find meaning and purpose. I'm going to experience pain no matter what, but at least this way it means something.
AG
PS BG, we cross posted, I just want to say I really agree with what you said.
Well, I had another session with T1 today and she brought up the text I sent last night where I apologized if I worried her. Today she said, "I did not worry. I have faith in you." and I said, "Okay good...because I was sort of worried that I had worried you and I do not want to be a difficult client who burdens you" and she laughed loudly and said, "You are NOT a difficult client". It felt great to hear that!!
So I don't think I freaked her out to the point that she will be terminating me yet. It feels good and makes me trust her more. T has told me that we will never have to terminate if I don't want to. I didn't believe it when she said it, but now I am starting to think she really means it (so long as I don't do anything crazy and tell her I love her!! lol)
Kashley,
you are right...the therapy is about me and I shouldn't have to look at T's needs. I am glad that she and discussed this today, even though we didn't dive too deep into it. I do think I would like to revisit this topic with her again when I am feeling a little bit more confident with bringing it up. Sometimes I just sort of freeze when we talk about issues in therapy and the irony is that it is usually the issues that I need to talk about the most that cause me to freeze up.
Jones,
I think you have pointed out something so important for us as clients to realize...that termination is more difficult to handle for the T's than we will ever realize. I did ask my T once if termination is hard for her and she said no, because it makes her feel good to see her clients reaching a point where they don't need her any more and have worked successfully through her problems. I guess I need to ask her if she has ever terminated a client for reasons other than no longer needing the therapy.
TN,
As much as I hate what happened with your previous T, I am happy to read that you can recognize that the manner in which it was handled was unethical and in violation of the APA. I do hope that someday you are able to pursue some action to have that T reprimanded for his negligent actions.
Also, TN, I cannot wait to read your Master's thesis someday! You have a wonderful topic that truly needs to be explored much more in depth than it has been to date.
MAC,
Your termination definitely constitutes abandonment! Completely irresponsible on the part of your T. In a way, you are fortunate that you won't be working with him any more because he does not sound like a good T, but still...I know it hurts like hell. You will be so much better off in the long run though. I just hope you are able to find a competent T soon. There sees to be a scarcity of them!
DF,
I cannot believe that your P terminated you via email in May. That seems so...unprofessional? and completely avoidant on his part. It is as though he took the easiest path possible for him to terminate and in turn, picked the coldest most difficult manner for a client to be told. Totally self-preserving on his part.
Sadly,
I agree....one shot terminations are unethical. There should be some sort of enforced guideline regarding the time between first notification of termination and actual termination. Like one month minimum, or something similar. Enough time to allow the client time to process, build up their support system, and find a new T.
BG,
Good question, "Has anyone done this appropriately??" It sounds like AG may be the only person who has experienced a positive termination! Pretty scary that there are so few examples of a positive termination.
AG,
When you wrote, "One of the things that was so sary about opening up with my T and moving closer was that all of my experience with significant figures in my life taught me that moving closer only got me hurt", it brought tear to my eyes. I sooooo relate to what you wrote there. That is the story of my life. Building close relationships is like laying the foundation for a ton of pain in the future. So much easier to just be avoidant.
It has been so nice to read about your positive termination with your last T, AG. It gives me hope....gives me something to stive for. It is comforting to know that it IS possible for a client to term with the T, and do in a way that feels positive for both involved. After reading so many stories of nightmarish terminations, your story serves as a beacon of light shining down hope on all of us. Thank you!
Butterfly,
I am so happy to hear that there is indeed someone else here who had a positive termination with their T. When she terminated with you, did she did it in a one-time session or did she give you some advance notice and time to process it before your final goodbye?
So I don't think I freaked her out to the point that she will be terminating me yet. It feels good and makes me trust her more. T has told me that we will never have to terminate if I don't want to. I didn't believe it when she said it, but now I am starting to think she really means it (so long as I don't do anything crazy and tell her I love her!! lol)
Kashley,
you are right...the therapy is about me and I shouldn't have to look at T's needs. I am glad that she and discussed this today, even though we didn't dive too deep into it. I do think I would like to revisit this topic with her again when I am feeling a little bit more confident with bringing it up. Sometimes I just sort of freeze when we talk about issues in therapy and the irony is that it is usually the issues that I need to talk about the most that cause me to freeze up.
Jones,
I think you have pointed out something so important for us as clients to realize...that termination is more difficult to handle for the T's than we will ever realize. I did ask my T once if termination is hard for her and she said no, because it makes her feel good to see her clients reaching a point where they don't need her any more and have worked successfully through her problems. I guess I need to ask her if she has ever terminated a client for reasons other than no longer needing the therapy.
TN,
As much as I hate what happened with your previous T, I am happy to read that you can recognize that the manner in which it was handled was unethical and in violation of the APA. I do hope that someday you are able to pursue some action to have that T reprimanded for his negligent actions.
Also, TN, I cannot wait to read your Master's thesis someday! You have a wonderful topic that truly needs to be explored much more in depth than it has been to date.
MAC,
Your termination definitely constitutes abandonment! Completely irresponsible on the part of your T. In a way, you are fortunate that you won't be working with him any more because he does not sound like a good T, but still...I know it hurts like hell. You will be so much better off in the long run though. I just hope you are able to find a competent T soon. There sees to be a scarcity of them!
DF,
I cannot believe that your P terminated you via email in May. That seems so...unprofessional? and completely avoidant on his part. It is as though he took the easiest path possible for him to terminate and in turn, picked the coldest most difficult manner for a client to be told. Totally self-preserving on his part.
Sadly,
I agree....one shot terminations are unethical. There should be some sort of enforced guideline regarding the time between first notification of termination and actual termination. Like one month minimum, or something similar. Enough time to allow the client time to process, build up their support system, and find a new T.
BG,
Good question, "Has anyone done this appropriately??" It sounds like AG may be the only person who has experienced a positive termination! Pretty scary that there are so few examples of a positive termination.
AG,
When you wrote, "One of the things that was so sary about opening up with my T and moving closer was that all of my experience with significant figures in my life taught me that moving closer only got me hurt", it brought tear to my eyes. I sooooo relate to what you wrote there. That is the story of my life. Building close relationships is like laying the foundation for a ton of pain in the future. So much easier to just be avoidant.
It has been so nice to read about your positive termination with your last T, AG. It gives me hope....gives me something to stive for. It is comforting to know that it IS possible for a client to term with the T, and do in a way that feels positive for both involved. After reading so many stories of nightmarish terminations, your story serves as a beacon of light shining down hope on all of us. Thank you!
Butterfly,
I am so happy to hear that there is indeed someone else here who had a positive termination with their T. When she terminated with you, did she did it in a one-time session or did she give you some advance notice and time to process it before your final goodbye?
Butterfly,
That's great that your former T gave you so much time to prepare for the termination. 4 months seems like a lot of time to have that looming ahead on the horizon, but it also seems like it would have given you more than adequate time to find a new T and to come to terms with the termination.
UV,
You have raised some interesting points that have really peaked my interest. It had not occurred to me how scary termination might be from the perspective of the therapist. I also am intrigued by your comment that your T had to terminate abruptly to avoid further harm to the relationship and to facilitate the process of breaking the transference by making you not like him any more. Very interesting indeed, and it completely makes sense.
That's great that your former T gave you so much time to prepare for the termination. 4 months seems like a lot of time to have that looming ahead on the horizon, but it also seems like it would have given you more than adequate time to find a new T and to come to terms with the termination.
UV,
You have raised some interesting points that have really peaked my interest. It had not occurred to me how scary termination might be from the perspective of the therapist. I also am intrigued by your comment that your T had to terminate abruptly to avoid further harm to the relationship and to facilitate the process of breaking the transference by making you not like him any more. Very interesting indeed, and it completely makes sense.
It's late and I'm tired but I just wanted to express here that we need to clearly differentiate between termination and abandonment of a patient. Abandonment is clearly unethical as stated in the APA guidelines. The only reason a T should ever abruptly abandon a patient is if the patient is threatening the T or the T's family.
Termination is a PROCESS not a one time session where you are handed a meaningless list of names and told to go find another T without any time to process it and no transitonal time nor support of any kind. That is just asking for a malpractice suit or licensing censure and any T that works this way does not deserve to be practicing.
I was abandoned on a Friday night. I had no new T to fall back on as it was a weekend and I couldn't even try to find one until Monday. My T left me in the ER the night before and never followed up on me... I was still his patient at that time with an appointment on his schedule ... instead he just went on his 3 week vacation and then sent me a termination email the following night. My newT who is VERY experienced, well-trained and knowledgeable in psychodynamic theory plainly said that my oldT was lucky he didn't kill me. That I could have DIED that night or soon after. It was THAT serious. And I do not think that my newT would say this unless he strongly believed it. It was only my inner strength and resilience and my sister and a close friend that pulled me through this nightmare time.
I am sorry that I cannot agree with anyone who thinks that this is the way to handle attachment and trauma in a patient. It is dangerous, lacks compassion, does harm and is unethical.
TN
Termination is a PROCESS not a one time session where you are handed a meaningless list of names and told to go find another T without any time to process it and no transitonal time nor support of any kind. That is just asking for a malpractice suit or licensing censure and any T that works this way does not deserve to be practicing.
I was abandoned on a Friday night. I had no new T to fall back on as it was a weekend and I couldn't even try to find one until Monday. My T left me in the ER the night before and never followed up on me... I was still his patient at that time with an appointment on his schedule ... instead he just went on his 3 week vacation and then sent me a termination email the following night. My newT who is VERY experienced, well-trained and knowledgeable in psychodynamic theory plainly said that my oldT was lucky he didn't kill me. That I could have DIED that night or soon after. It was THAT serious. And I do not think that my newT would say this unless he strongly believed it. It was only my inner strength and resilience and my sister and a close friend that pulled me through this nightmare time.
I am sorry that I cannot agree with anyone who thinks that this is the way to handle attachment and trauma in a patient. It is dangerous, lacks compassion, does harm and is unethical.
TN
Well said, TN. Maybe I should stop refering to our terminations as terminations and just as abandonment.
quote:I think I have a different view of attachment therapy than most on here because I'm not 100% sure if building your own identity is something most on the board would define as an eventual goal in attachment therapy? I do..
Hi DF,
I don't want to pull the thread off topic but I did want to answer this. I'm not at all upset by what you said, just wanted to make clear what it is I believe.
I absolutely believe that the end point of good therapy and as a matter of fact, the point at which you terminate is by forming your own identity. The end goal of parenting and human development is that we differentiate from our parents, learn we are a separate person with our own feelings, needs and desires and venture out to live fully in that knowledge. But I think there are two concepts which are leading to some confusion around the subject of attachment.
The first being that because we speak so much of dependency being a good thing when healing from attachment injuries, it can sound like there isn't a desire to go beyond the dependency. Nothing could be further from the truth. All human beings are born dependent. The current state of neurobiological research into brain structure shows how all human beings have neuroplasticity, that the brain actually changes its structure in reaction to its environment, experiences and relationships. We are born without our frontal cortex really up and running, but with our limbic brain fully there. The limbic system stores our implicit memories. Think of the fact that you know how to read or tie your shoe but don't really remember learning it. Because humans are a social creature, evolutionary forces favored caregivers who took care of their young, and young who attached to their caregivers. We are born without the ability to regulate our own nervous systems and it is through interacting with an attuned adult that the knowledge is transmitted. There is literally a whole section of our frontal cortex that is dedicated to interacting with others, and sensing their internal state in order to understand them. The more attunement you get (secure attachment) the more robustly your brain develops in this area. (Not to get too technical but while your nervous system is based on your genetics, how your brain grows in terms of how many neurons develop and how the synapses connect them are directly affected by these interactions.)
So the basic belief when applying what they have discovered about attachment to clinical practice is that all human beings have to pass through a stage of dependency in order to learn what they need to be able to be independent, well, actually interdependent, but that's my second point that I'll get too soon. We're supposed to do that when we're children because we learn it faster and easier and make it a more integral part of ourselves then because the brain is developing at such a fast pace and is easier to change AND it is highly appropriate for a child to BE dependent in relationship to their caregivers. But if we don't get what we need, it literally arrests our development in some areas. But being dependent all the time as an adult is neither appropriate or healthy. And that's where therapy comes in. It was my experience, which matches up with a fair amount of research, that my T allowing me to be dependent on him for a time is how I actually learned what I needed to cope on my own. Dependency wasn't the end goal, it was a necessary stage that all human beings have to past through in order to fully develop as individuals.
Which leads me to the second concept which gets in the way; the concept that the end goal is independence. That we need to reach the point where we don't need anybody. Rugged individuality is highly valued in Western culture, especially in the US. But the truth is that human beings NEED relationships, we are happier and healthier when we form deep, lasting attachments, and since we can only come to know ourselves in relationship to another person, we grow best as we can allow other people in. Which is why I believe that the goal should be interdependence. When we form deep attachments there is natural flow back and forth, that we reach out to others to get our needs met, but at other times we are reached out to in order to fulfill another needs. The dependency switches back and forth in a sense. There is also the need to be able to take care of ourselves if someone else is not available in the moment to meet our needs (this is the independent part.) so I think the whole concept that we will reach a point where we will find everything we need inside ourselves is an impossible goal because we'll always need others. On the other hand, in order to be healthy we do need a strong sense of self and the knowledge of where others begin and end in order to interact in a way that is beneficial to both people in the relationship which is why good boundaries being modeled is so important.
AG
DF,
Glad it clarified things! I do want to reassure you that I have never seen you as denying the need for attachment or how it is part of development. That's why I wanted to respond to what you said, it was out of a feeling that we were saying the same thing but something was missing. I really love reading your posts and the way that you approach your healing and understanding of the process. I also found it really helpful to lay that out in that post, I'm not sure I've ever quite clarified it that way, so thanks for providing the opportunity!
AG
Glad it clarified things! I do want to reassure you that I have never seen you as denying the need for attachment or how it is part of development. That's why I wanted to respond to what you said, it was out of a feeling that we were saying the same thing but something was missing. I really love reading your posts and the way that you approach your healing and understanding of the process. I also found it really helpful to lay that out in that post, I'm not sure I've ever quite clarified it that way, so thanks for providing the opportunity!
AG
I was thinking about this in terms of attachment and also what DF said concerning enmeshing and forming a separate identity. Having a separate identity and knowing that while you can rely on someone else, you are still a whole person without them is important to me. But I really think (or have started to think recently) that my whole reaction this “thing” with my T is appropriate and healthy… (I’m going to compare the therapeutic relationship to that of a mother/child even though it can sound weird) If a mother told her securely attached young child that she was leaving her forever that child would feel destroyed. The pain would lessen with time, and even if another maternal figure was found in the future, no one would replace her mother. But if the dismissively attached child had her mother tell her she was leaving forever, the child would hug and kiss her goodbye and then find a new mother to attach to. In any relationship I’ve had in my life people are completely replaceable, I think I’ve said before on the forum, that I feel at home in anyone’s bed. People leave me, and I move on like they never existed. But that’s exactly what I don’t want to happen with my therapeutic relationship… I really feel like my T just wants me to brush it off and say, “Well, it was nice knowing ya!” And then attach myself to someone new. That would be unhealthy, right? I don’t know, it makes sense in my head though!
nooooooooo totally not! I was happy to think that my reaction might actually be okay... despite the way my T is treating me. I mean cus i thought/and still think that i'm just weak and needy and childish. but i kinda think just based on attachment theory that this is right? i dont know!! My T definitely doesn’t think it is! well thats not explaining it well either but whatever 