Ready to Move On from Therapy … but How?

When the therapist I had been seeing for a very long time, on and off, suddenly became ill and had to leave her practice, I was miserable. I decided to see the therapist who was recommended to me to help me with my grief. That was four months ago, and I think I am OK with the loss. Now I don't really know why I would want to remain with therapy and what direction it would take. But I can't seem to end it. This was an issue with the first therapist as well. And I don't feel like exploring this as it hasn't helped me in the past. I wrestle with this issue almost constantly. My inclination is to go to the next session and tell her it will be my last. I just feel it would be the only way I could leave. Talking about leaving just isn't something I want to do. —Enough is Enough
Dear Enough is Enough,

Thank you for your question.

Saying goodbye is painful, but the ability to begin and end a relationship kindly and in full consciousness is a hallmark of acceptance of self and other—of reality. You write that you were in treatment on and off with your previous therapist for many years, and with this latest person for several months. It’s interesting that you don’t feel like exploring what it is to say goodbye, “as it hasn’t helped … in the past,” and that you “wrestle with this issue almost constantly.” Wrestling with something “almost constantly,” as you write, is a clear indication that the issue is important to you and hasn’t been resolved.

I imagined talking to you—saying a full hello and a complete goodbye, too, so I’ve put together a kind of make-believe conversation between us. I hope you don’t mind. And please feel free to add, change, agree, disagree, or comment on the following. I’d love to know what you think.

What are some reasons people can’t say goodbye? Here are a few, and I’m sure there are many more that you or someone else can add. So here goes our conversation, imagined by me, as I make believe that I am your therapist. You start the ball rolling; the italics stand for you, talking.

What if I can’t make up my mind?

If you can’t make up your mind, that’s an important thing to talk about. Do you have this issue in other areas of your life?

It’s so final. Does it mean we will never see one another again? Or think about one another again?

Of course we will think about each other sometimes. Why wouldn’t we?

We were close before. What happens to that closeness? To the history that we shared?

That history will always be a part of us.

What will you think of me after I leave? Will you still like me, or not?

My feelings about you don’t depend on your presence or your absence, but on who you are.

What will I think of you? What if I miss you? That would be hard.

Not everything is easy; missing each other is OK. Saying goodbye is sad.

What if I don’t miss you at all? What kind of person does that make me?

That will make you a person who doesn’t miss me. That’s OK, too.

I really miss my first therapist.

Ending the treatment with the new person symbolizes the end of treatment with the therapist you saw the longest and who probably means the most to you. Ending with your original therapist would have been more natural and better for everyone. Too bad that person is no longer able to continue working. It sounds to me as though you had a wonderfully warm and helpful relationship.

I feel defenseless.

You may feel defenseless, but you have learned strategies that will help you get along.

So, how do you end therapy? I want to just stop. Or go one last time and say, “This is it, I’m not coming back.”

Generally when therapy draws to a close, the therapist and the client choose an ending date together. The end of treatment, called “termination,” is a time when many important matters come to the surface and should be dealt with. This may take a few weeks or perhaps months.

I don’t know how I feel about all this. I’m sad and angry at the same time.

You may be experiencing many conflicting emotions at this time: sadness, love, and anger, for example, and you should let them out. Speak up and talk about your feelings.

So now what?

You may have many questions, like what happens next, or, what if I need treatment somewhere down the line, or even, what if I change my mind? State your feelings and ask your questions.

What if I’m not ready?

You may feel uncomfortable, but that doesn’t mean necessarily that you are not ready. It’s just hard to do.

I think I’ll just stop. It’s easier.

Say goodbye face to face and eye to eye. People sometimes chicken out when they get to this stage. Do yourself a favor and say goodbye in person. It’s honest, caring, and respectful to all concerned. By the way, I’ve been a therapist for a long time, and I have many fond memories of the amazing people I’ve worked with. The door is always open.

Sincerely,
Lynn