Hi Dharma,
Welcome to the forums! I'm glad you took the risk to post and con gratulations on making so much progress in therapy. It's a lot of hard work and you should be proud of what you've accomplished . I really relate to what you're saying as I've recently made a lot of progress and am considering if it's time to leave. I was actually kind of obsessing over it and when my T and I discussed it, I was able to realize that I'm trying to leave before I've outlasted my welcome since I have a dread of being somewhere wher I'm unwelcome. My T was able to reassure me that being unwelcome wasn't going to happen (for the 126th time, I might add ). Then we talked about what ending would look like and how it would happen. I came away with a sense that it will be a pretty organic process that will happen fairly naturally. But we
also discussed the fact that this has been a very deep significant relationship for both of us (moreso for me obviously) and that it would be hard and sad for us to stop having sessions (although he has also made it clear that his door is ALWAYS open to me.)

This is all my longwinded way of saying is that how you ate feeling may be a reasonable emotional response to leaving someone you deeply care for who has helped you
so much. On the other hand, it could be that the thought of leaving is bringing up
stuff you haven't dealt with yet and need to look at. My advice would be to ask your therapist what you have asked here and explore you're feelings surrounding leaving. It sounds like you have an excellent open relationship with your T and she has clear boundaries so I believe she would welcome a chance to discuss this with you. Keep us posted!

AG

Hi AG,

Thanks for your response! I’ve been reading a lot of your posts and was hoping you would be among those who respond. If I recall correctly, you’ve been in therapy for a long time. Per your post to me, you may be considering termination and that you’ve talked to your T about how it would happen. I hope you don’t mind my asking, but are you considering a final session or gradually decreasing the frequency of sessions, and why are you considering one method over the other?

It’s not always easy, but eventually I tell my T everything I think and/or feel. She knows I have a problem with leaving and has made it known that her door is always open for me. I can’t begin to think about having a final session, so I’m opting to gradually decrease the frequency of our sessions . . . when I’m ready. My only problem is based on the following article regarding one therapist’s perspective regarding termination methods:

“Some clients want to terminate gradually by decreasing the frequency of sessions from weekly to every other to every month to every quarter. Fading away is not termination; it's mitigating the difficult feelings associated with ending. Cutting back sessions communicates: "I can handle seeing each other less often and with less intimacy, but an absolute ending is too much." Two sessions per month or less becomes "checking in" and we spend most of the time reacquainting with one another rather than diving into deeper work. The flow and continuity of therapy eventually weakens, changing the quality of the relationship. When clients tell me they'd like to cut back their sessions, I take it as a sign they're thinking about terminating and suggest we begin termination instead. This way, the corrective experience of facing and grieving an ending head-on isn't lost. This point comes from experience. I've done the fade-away many times, and after a couple bi-weekly sessions and a monthly or two, clients typically disappear. The significance of the relationship diminishes so they simply drift away. But they're depriving themselves of the closure, the summary and the goodbye”.

I simply do not want to leave either way (1) gradually = less intimacy and no closure or (2) never seeing her again. I know I’m a black and white thinker, but what other option is there. I may sound unemotional when writing, but I can’t even begin to tell you how awful this feels. I will see my T in a few days and we are both expecting to talk about this. Thank you for giving me the opportunity for thinking this through, and I do appreciate any and all feedback.

D

Hi Dharma,
I don't mind you asking at all; actually I welcome the opportunity to discuss this because I am also trying to think it through and I have been wrestling with the same dilemma: decrease sessions or set an end date? I've read the article you quoted (Ryan Howe at Psych Today right?) and I understand the point that he's making. BUT...

I don't agree that decreasing the frequency of sessions is necessarily a fade out to avoid the pain. I think of it more like a kid going off to college. They're away for longer and longer periods of time, but they come for holidays, weekends and even a long winter break. In some sense, they keep one foot in their family while venturing out with the other foot into the world. At the end of four years (and usually by then visits home are fewer and further between) they graduate and actually leave home altogether to go out and make their own lives. But in times of stress or trouble, their family is still there and they would be welcome at home if they needed to come back for a while to get through a rough patch. I think leaving therapy is a lot like that. I know for me that it has definitely felt like a process of growing up, especially because so much of my work has centered around forming a secure attachment and learning to regulate my emotions and express my needs. All the stuff I should have learned as a kid. So in many ways I feel like leaving therapy is going to be like leaving home.

I actually told my T at one point that beyond all hope he had showed me what home really meant. I wrote a poem about it which is posted in this thread: Finding Home
So this seems to fit for me.

And when I discussed leaving with my therapist, I was thinking that we'd do it the way discussed in your quote. Set an end date and stop but when I talked to my T last week, he told me he didn't agree with the way a lot of therapists think about ending. He doesn't really think there's an end, because his door is always open, I'm welcome to come back. That as I need him less, I'll come less until we both realize that its time for me to go. But as long as I'm growing and want to come, he's fine with that happening. And after what I've been through with my T and the healing I've done working with him, I'm going to trust him on how to end this.

And I trust you on how awful this feels. Sometimes I can contemplate leaving with a great deal of equanimity but at other times with a gut wrenching sense of loss but it's getting better. Part of that is I am so much more secure with my T now and I have such a stronger sense of him within me that I'm starting to believe that we may be physically apart but that I will carry him with me when I go. And though I know it will be painful to say goodbye, that I'll be able to handle the sadness. Grief is the price we pay for the love we've known. But I've done it enough times to know that its worth it. And there's no need to be scared of sadness or grief, they're both a part of life. Not the most fun mind you, but part of what it means to be human and they can be embraced like anything else we experience. I think what I'm groping after saying is that if we engage fully and don't fight against it, we grow through our pain and that gives us more compassion and capacity to help others who face what we did. And that's how love answers pain.

OK I got a whole lot more philosophical than I intended sorry! It really does feel like its going to be really hard to leave but its also starting to feel like something I need to do. Maybe just to find out if I can.

BTW I forgot but yeah I have been in therapy for over 20 years, I saw my first T on and off from 1986 until she retired about four years ago and have been seeing my present T for about five years (two in couples counseling and the next three for both couples and individual) so this won't be the first time I've left, but it does feel like the hardest.

Thanks again for asking, it's really helping me to try and articulate how I'm feeling. I didn't even realize I thought some of this stuff until I found myself typing it.

AG

HB and AG,

Thank you both for your replies! I’ve read them several times and your responses stir a lot of emotions and I can’t help buy cry. This is the hardest thing I’ve done in my life. I don’t leave people I love and care about. I’m feeling so much pain and conflict, yet I’m still seeing her once a week. Obviously I still have some work to do before I leave therapy.

AG – I fell apart when I read “Grief is the price we pay for the love we’ve known”. I do understand what you’re saying and agree that love is worth it. I know and believe that we can hold someone in our heart forever and keep the love alive, but I’d rather have them with me. I’ve lost many people in my life, but I’ve never been faced with planning it. I know I’m not getting anywhere by fighting it.

HB – Thank you for sharing your experience. I would like to end therapy slowly and I hope to get to where you are now without suffering.

Thanks again for sharing your thoughts and experiences. It’s nice to know I’m not alone.

D

quote:

I’ve lost many people in my life, but I’ve never been faced with planning it.

Dharma,

That absolutely nails the dilemma of saying goodbye in therapy. It's one thing to lose someone because of circumstances but why in the world would I choose to leave someone I love? I think answering that question is going to be interesting. And I agree, it's nice to know I'm not alone. Thanks for discussing this.

AG

Hi Dharma and welcome to the Board. You pose very interesting questions and I have read all of the responses. I don't think there is any easy answer to this. I have been seeing my T for two years now and the thought of ever leaving him terrifies me and sends me into tears of grief. It's even hard for me to read this thread. I don't agree with the article you quoted and I don't believe there really has to be a final good-bye when you leave. So for me, if I ever get to the point where I leave it will probably be the slow, fade-out type of leaving with the possibility to return if/when I felt I needed to. My T has also told me that I could come see him forever if I wanted to, that his door is always open and that it is my choice when to leave. On the other hand if he felt that there was no more to be gained or that we were not accomplishing anything he would discuss it with me but still not ask me to leave. I cling to these promises as I work through trauma and attachment injury from childhood.

I think what HB and AG (two very wise women) said about leaving makes so much sense to me. The gradual phasing out, and especially the analogy about children growing up, leaving home, and going off to college or eventually their own lives is more along the lines of what I'm thinking. I think in the case of having a final termination session or a pre-planned, set in stone kind of ending may work better with clients who have come to therapy to solve a particular issue or phobia or are even just doing a set amount of CBT sessions.

I think what you said about planning a huge loss really resonated with me. As AG so aptly states, why would I choose to leave someone that I love? At this point in my therapy I cannot even begin to imagine it.

TN