COMMITMENTS : Cutting the Cord : Saying goodbye to your therapist can elicit bad feelings--unless it’s handled right. Then the parting can be a chance for growth.
You’ve been in psychotherapy for a while and feel your therapist just isn’t meeting your needs anymore, so you decide it’s time for a change. Or perhaps it is your therapist who is moving on--leaving town, going on maternity leave, retiring because of age or illness.
Whatever the reason for bidding adieu, when the two of you part company, you’re not just breaking off with a mental-health professional. Therapy involves transference, in which you transfer feelings about important figures in your life onto the therapist. So you’re also saying sayonara to your mother, your father, significant others past and present, best friend, maybe a sibling or two--so many people it’s a wonder you can all fit into one office.
That period of wrapping up therapy and saying goodbye is known as “termination,” a word that evokes images of being fired from a job or being stalked by Arnold Schwarzenegger. But mental-health experts consider termination a crucial stage in therapy.
If handled properly, it provides an opportunity to re-examine the issues that led the client to seek help in the first place, to evaluate the therapy itself and to deal with feelings that might bubble up in the face of bidding farewell.
A so-called natural termination, in which the two of you agree to end treatment because your goals have been met, is difficult enough. Who, after all, likes to say goodbye, especially to someone who has helped you so profoundly and so intimately? But a premature termination, where a dissatisfied client leaves without much notice or a therapist departs before the patient is ready, can be downright traumatic.
“It’s always best if people can have time to pay attention to the process of saying goodbye,” says Carl Shubs, a licensed clinical psychologist in private practice in Beverly Hills. “If people leave too abruptly, it interferes with the process--they’re not able to deal with the sadness or anger, the mourning that occurs.”
Adds Sylvia Martin, a licensed marriage, family and child therapist in private practice in Sherman Oaks: “Termination is a time when people start to deal with all their losses. It can trigger feelings about old issues, or issues about the relationship between the therapist and client.
“If there is an old loss they have not grieved, they will tap in and experience the same feelings,” she says. “Maybe they had a feeling of abandonment when they were young and did not understand it. Or maybe they have not had the luxury before now of dealing with a loss--for example, going through a divorce with two kids.”
*
If it is the patient who says so long, a good therapist will try to determine if he or she wants out because the topics being discussed are becoming too painful. In those cases, the therapist will encourage the patient to remain, so as to work through the discomfort and resolve those issues.
Many times, though, the client is willing to slog through the hard stuff, but feels this particular therapist is less than able. Such was the case last year for Laura, 41, who works in the travel industry in Orange County and sought counseling for marital problems.
“I was therapy illiterate,” she recalls. “I had no basis for comparison. But I never felt I was getting help. I would drive home and think, ‘Why did I just go there?’ I didn’t expect a magic cure, but I was just begging my therapist, ‘Give me some tools to help me.’
“All she said was, I had to divorce my husband, which I wasn’t ready to do. I felt her attitude was, ‘You won’t take my advice, so I don’t know what to tell you.’ ”
Laura--who is still married and on better terms with her husband--found another therapist to her liking. But she stuck with her first counselor longer than she preferred to because, she says, “The last thing I wanted was to look for someone new to spill my guts to, to start over again.”
Indeed, for some people, leaving the current therapist is the easy part; it’s finding a new one that poses problems. Says Studio City writer Catherine Johnson, author of the book “When to Say Goodbye to Your Therapist” (Simon and Schuster, 1988), “Finding a new therapist is not like finding a new dentist. It’s extremely difficult to find a match.
“It’s a bit like finding a lover, or best friend, or a parent. You don’t just go out and find a new best friend. You have to find a real emotional fit, on top of basic competence.”
Lisa Moore, 34, a West Los Angeles advertising account executive, discovered that last year when she left the marriage and family counselor she had been seeing for 15 months because she thought the therapist had crossed the professional line and was becoming too friendly. After six weeks with a new therapist recommended by her physician, she decided to return to her former counselor.
“My first therapist was very comforting,” Moore says. “I was in a raw state of emotional upheaval, and she kept me focused and organized and centered. The new woman gave me good advice, but she was cold and distant, like a stranger. At one point, she asked if she could eat a sandwich, because she hadn’t eaten all day. I didn’t object, but I thought, ‘What is this?’ ”
*
Breaking up with a therapist can be particularly unnerving for a patient when it is the therapist who initiates the end of the relationship because of a change in his or her own life. Professional ethics dictate that the therapist not just abandon the patient, that he or she provide appropriate counseling and referrals to a new therapist, but the patient may read it as desertion nevertheless.
Some years back when she was in training, Martin recalls, interns were not allowed to take clients with them when they moved on.
“I felt bad about that,” she says. “I had a long termination process with my clients. A year later, one of the women tracked me down. She said, ‘I was so angry, even though we went through the process and I found somebody else. I wasn’t ready to finish.’ ”
Because of the forced nature of the termination, saying goodbye to the therapist is especially liable to elicit feelings, conscious or unconscious, about other departures the patient has experienced.
Even a woman who comes from a military family and is accustomed to frequent farewells discovered that she had mixed feelings when her therapist told her he was moving out of state. “I was going to be going through a messy divorce and, even though I felt very confident, I’d hoped he’d be there,” says Diane, a South Bay educator in her mid-30s.
“It felt the same as when a very close friend moved away. I still think about [the therapist] a lot. When I’m very stressed, I think, ‘What would he say?’ And I missed him when my dog died.”
Not that leave-taking is necessarily easy for therapists, who feel responsible for their patients. Kathryn Fraser, a clinical psychologist and licensed marriage, family and child counselor, moved from Downey to Irvine three years ago, but continues to drive to Downey once a week to counsel some patients.
“Two or three suffered from panic or anxiety attacks, with some agoraphobia along with it,” she says. “I had some concerns about their feeling abandoned.”
For those patients who do part company prematurely with their therapists, it might be helpful to put a positive spin on the process. After all, Martin says, “Termination is very important. You can’t have a new beginning without an ending.”