Ideally, the decision to end is one that’s initiated by the client and mutually agreed upon by client and therapist, after a period of discussion. Ending consciously and with intention can be a very powerful and emotional experience, as ending therapy is actually ending a very important and intimate face-to-face relationship. - Carol Gould
When Is It Time To Stop Therapy?
by Carol Gould, Licensed Marriage and Family Therapist
In my practice, it’s not unusual to have a client ask at
some point during our work together, “How will I know I’m ready to stop
therapy?” It’s a good question, with
many layers of meaning. When you are
immersed in a long-term therapy, which by its very nature is fluid and
open-ended, it’s understandable that at some point you might start to wonder
“Will this ever end?”
When you’re in long-term therapy it’s hard to predict when
you’ll be ready to end it, although that doesn’t necessarily mean you won’t know
when the time comes. The human psyche is
a deep treasure trove of experience—memories, thoughts, and feelings—all
stimulated by what is happening in your life and in the relationship between
you and your therapist. As long as you
experience that relationship as dynamic and stimulating, you can benefit from
therapy because the relationship is constantly bringing up material to be felt
and processed. For some people it seems
as though this could go on forever, but most people reach a point where they feel
it’s time to stop. How will you know
when that time has come?
For some people, a crisis is the catalyst that brings them
to therapy. Once the crisis is resolved,
many people continue with treatment with the goal of dealing with the issues
that contributed to the crisis. This is
a process that usually takes at least at least a year and often longer. As long as you feel you are actively working
on something, it’s probably not time to stop.
However, you may reach a point where you don’t feel you’re actively
working on anything. You may feel that
the quality of the relationship with the therapist has lost its vitality—its
“punch,” so to speak—and you are covering old territory with no new scenery in
sight. It is useful to talk about this
experience with your therapist, as sometimes what seems like an impasse is
actually a precursor to breaking new ground.
In some part of your being, you’re waiting to see if it’s safe to
progress to the next level, and talking about the impasse can create a more
solid sense of safety. But sometimes
even after talking about an impasse there’s a sense that the work is done with
this particular therapist at this particular point in your life. It’s important to give this discussion the
time it needs, so you can be sure you’re not ending therapy prematurely.
Many people return to therapy multiple times throughout
their lives, as major life events bring up new challenges: leaving home and
striking out on your own, marriage, career, the arrival of children or the
decision to not have children, illness, death of a spouse or child—the list is
long. Or, a problem that seemed resolved
over a course of therapy begins to manifest in your life again. Many people will go back to the same
therapist to do serial pieces of work, and other people will choose a different
therapist to do their next piece of work.
Ideally, the decision to end is one that’s initiated by the client and
mutually agreed upon by client and therapist, after a period of
discussion. Ending consciously and with
intention can be a very powerful and emotional experience, as ending therapy is
actually ending a very important and intimate face-to-face relationship. Talking about feelings that come up when the
end is in sight is sometimes the first time a person has truly said goodbye to
someone they feel close to, and it’s an important experience to set the stage
for future endings.
Sometimes people feel they need to end therapy because of
schedule conflicts, financial stress, or other logistical complications. These complications are real, but sometimes
other motivations exist out of our awareness.
I have found that it’s not uncommon for people to talk about ending
therapy three or four months into the work.
The work has progressed well, but suddenly the client feels that she
can’t afford therapy, or there’s a schedule conflict, or some other tangible
problem has arisen that causes her to feel she can’t continue. In this case, what often eventually emerges
is that the client is uncomfortable with the sense of dependency that develops
as a result of the therapist’s empathic responsiveness and caring. For some people, dependency feels
dangerous. Childhood experiences of
dependency were laden with disappointment, fear, and shame because the parents
were unable to meet the child’s emotional or practical needs. When these needs aren’t adequately met for
whatever reason, the child learns not to count on the environment for
support. They find ways to cope, but
usually those coping strategies involve an undue burden on the child to manage
situations beyond their emotional or intellectual capacity. When their dependency needs are inadequately
met, children feel they’re wrong to have these needs. It’s a psychological strategy to manage the
profound sense of fear and helplessness in the face of an unmet need for
support, help, comfort, or survival. The
child develops a sense of shame around the normal tendency to depend on their
parents. Consequently, the desperately
longed-for need for understanding, empathy, and responsiveness brings with it
an unbearable sense of shame as the client has the experience of feeling cared
for by the therapist. Without really
being aware that this is going on, some people perceive a schedule or financial
conflict as an insurmountable roadblock to their therapy. While it’s sometimes true that external
factors necessitate ending therapy prematurely, more often than not when client
is able to talk about the experience of needing the therapist, she finds a way
to resolve the logistical conflict and continue on. The experience of exposing her dependency
needs and the attendant shame in the therapeutic setting is calming and
soothing, and provides a new relational context in which to discover that dependency
can bring a sense of peace and safety rather than fear and shame.
Similarly, people who experienced early childhood trauma
such as abuse learn that being close to other people is dangerous. When these fears are out of the person’s
awareness, the experience of feeling close to the therapist triggers the
impulse to flee but the perception is that some external factor is the
catalyst, not the therapy.
Some people choose to be in therapy for long periods of
time, not just to resolve problems but to increase self-awareness and foster
personal development. Most of the time,
though, people stay in therapy until they feel they’ve achieved an adequate
degree of confidence that they can cope with the challenges of life, including
the attendant emotional states. It’s
important to explore with your therapist those moments when it seems that it’s
time to stop, in order to create an opportunity to discover deeper issues that
may have been activated by the intimacy of the relationship that’s developed
between you and your therapist. If the
two of you stay open to the possibility that ending may be a door to further
psychic exploration, you are very likely to know with reasonable certainty when
it’s truly time to end.
Carol Gould is a master therapist who trains other therapists. She has had a private practice in Noe Valley since 1995, working with individual adults and couples. Her work is informed by Self Psychology, Relational psychoanalytic theory, Control Mastery Theory, and Intersubjectivity Theory. She has been trained in John Gottman's couples therapy model and Emotionally Focused Therapy. You can learn more about her work or schedule appointments by contacting Carol at; 415-826-5435 via her website.
Labels: Carol Gould, endings, goodbye, loss, Unconscious Patterns
