Endings often mean new beginnings. How can you walk away gracefully and manage all the feelings? After terminating with fifteen therapy clients by the end of my internship and supporting hundreds of people with finding new therapists, I can tell you that breaking up is hard to do, and yet, when done well, letting go can liberate you.
The natural cycle of mental health therapy includes termination. Clinical trainings and supervision include theories around what ending treatment brings up for clients and clinicians.
Despite the rumors, therapy doesn't last forever. Recovery is real and attainable. At some point, you'll start feeling like yourself again. You'll kick your addiction, or develop a coherent life narrative that no longer triggers you. You'll feel ready to move along on your own...#goals
Sometimes the endings are "forced"; one of you is moving or changing roles. The clinic or your insurance may only cover a certain number of sessions.
Finances can get in the way; maybe you lost your job or the therapist increased their fees. Other times, scheduling or the commute just can't work. Whether it's your busy schedule or the therapist's limited availability, many professionals can't make weekly meetings on Tuesdays at 2pm. Sometimes payments, communication, and scheduling can be clunky and feed into the relationship too.
Oftentimes though, people break up with therapists for more personal reasons. Do you feel respected and understood? Are you discussing what matters most to you? Can you learn from your therapist? Do you see your therapy goals similarly?
What's Your Therapist Thinking?
Therapists often rationalize terminations as happening because the client wasn't ready. That's often why therapists describe their ideal clients as motivated.
Therapy isn't a walk in the park; you're stirring the pot and intentionally sorting through your most challenging concerns. It's not always the right time in your life to go there.
Sometimes clients start therapy overflowing with traumatic experiences. After revealing so much so fast, clients can feel triggered and dissociated. Then, avoidance naturally kicks in.
It's important to establish a therapeutic alliance and practice some coping skills before delving into traumatic content.
Does your therapist seem trustworthy? Does the room feel like a safe space? Can your therapist help bring you some peace of mind after sharing troubling experiences?
Otherwise, you might find yourself running far away and that's okay.
More often though, I've heard therapists blame themselves for not being helpful enough. Many may review the last few sessions wondering what they could have said differently.
Some wonder whether another therapist with more relevant experience or training may have been a better fit. Or could they have spotted the signs earlier, and repaired the relationship before it was too late?
Goodbyes are Uncomfortable
People don't just wake up and leave relationships. Over time, we assess new people's roles in our lives and decide whether to move closer or pull away.
When considering breaking up with a therapist, people often start missing more sessions. When clients start rescheduling or cancelling more frequently, therapists may wonder whether these are subtle signs of an upcoming termination. Some other nonverbal signals include clients arriving late, frequently crossing their arms, or being less receptive to the therapists' perspective.
Once the decision is made, having to break the news becomes the next hurdle. At this point, many clients ghost.
Some may no-show or stop returning calls or emails. Others may send a short email or call the office staff to cancel any upcoming appointments.
Even when you'd rather not continue seeing your therapist, ending on good terms can be beneficial. Many don't realize that potential record requests or insurance logistics mean you'll need to interact again after you stop therapy.
Therapeutic Value of a Positive Termination
What if breaking up with your therapist could also help make endings more positive in your life?
Ending a relationship often brings up memories of other endings in your past. The opportunity to walk away on good terms helps model leaving other situations and having it turn out well.
Therapists often give clients 3-6 weeks notice if they can't work with them anymore. This leaves enough room for reflecting on progress and brainstorming future therapy goals.
My clients' responses to my internship ending varied. Many worried about finding a new therapist and appreciated some referrals. Most were anxious about starting over, needing to find another therapist who's compatible, and having to coordinate logistics around scheduling and payments again.
The nearing end was a big elephant in our small therapy room.
Terminations are difficult for therapists too. My sessions started running long; I thought of all the things we didn't get a chance to work through yet. Some clients shared new major challenges they wanted to process before separating, but we had little time to do so.
I found myself overcompensating with resources before we had to say goodbye, as if five more worksheets could help with all their complexities.
Our final sessions were special though. After reviewing my notes from our sessions, we celebrated my clients' progress towards their self-proclaimed goals and shared turning points we noticed in our work.
Transitional objects can be sentimental too. I shared a picture with a favorite quote for each client as a parting thought. I find myself looking back at these from time to time too.
Many therapists figuratively leave their door open if you ever wanted to return, which can also be comforting.
Someone with context to your challenges, family dynamics, and concerns could be a priceless resource if you're in a crisis down the line.
Different Therapists For Your Life Stages
After completing hundreds of intakes for clients seeking therapy, I noticed that oftentimes people have had a handful of therapists they've consulted throughout their lives.
Consider therapy similar to peeling an onion. As you work through layers of Depression and Anxiety, for example, you may find Obsessive-Compulsive tendencies; for many people working through Addiction, you may uncover some unresolved Trauma.
A cornerstone sentiment for therapists is "meeting clients where they're at". That means it's understood that you likely won't be ready to face everything at once.
Therapists often see this throughout the course of treatment, as clients bring up new core challenges after months of sessions.
As you move through different life stages, you might realize that a new therapist may be a better fit for your therapy goals. A therapist who specializes in Depression may not be as familiar with Bipolar Disorder. A clinician who's highly skilled in improving Generalized Anxiety may not be as comfortable working with relationship challenges. Depending on a therapists' specialty, they may also nudge you to explore different directions, which may or may not align with what you'd like to focus on at this point.
Consider what demographics make you the most comfortable. Maybe a younger female feels especially relatable, or a male person of color may seem inherently more understanding of your challenges.
Seeing a series of therapists who remind you of past difficult relationships can also help you rise above them.
Many clients internalize their therapists' perspective as a more constructive inner voice over time. After growing up with highly critical parents, for example, a therapist's kind and encouraging words can gradually replace self-defeating beliefs potentially implanted by your family. A male therapist may offer you a protective, reassuring voice, while an older woman may model supportive and caring maternal qualities.
Early negative experiences may also color your relationships with men or women of different ages and backgrounds. This transference can be worked through with a therapist who pushes your buttons in similar ways.
Feedback is a Gift
Since goodbyes are uncomfortable and often trigger difficult memories of painful endings, clients rarely provide feedback to their therapists before terminating sessions. Feedback is a gift. Feedback is also challenging to deliver kindly.
Relationships are a series of ruptures and repairs. Oftentimes, raising concerns and seeing them addressed make relationships stronger. It's powerful to have someone care enough to respond appropriately to your feedback.
Articulating your unmet needs or things that have rubbed you the wrong way provide you the opportunity to practice assertiveness. For some, it seems pointless to share misgivings, oftentimes because they've been ignored or diminished in the past. Sharing feedback with your therapist can be a therapeutic opportunity.
What if someone affirms that your feelings matter, takes responsibility for their actions, and takes meaningful steps to remedy the situation?
Therapists aren't perfect though. It's tough not to personalize clients who don't find your sessions helpful. Some may react defensively or without tact. This can also validate your gut feeling that something's off.
Since therapy is mostly indirectly supervised, your feedback provides therapists with priceless suggestions on how to refine their craft based on your direct experience. Therapists inherently want to provide more positive experiences for their clients and may not realize how their words or behaviors may be landing. Maybe they've been checking the clock too often or frequently leaving you waiting while their earlier session runs long. It's worth noting how this makes you feel.
Therapists may see 20-25 weekly clients, which can amount to thousands of clients over their career. Your courage to provide constructive feedback can therefore improve thousands of other peoples' therapy experiences.
How To Break Up with Your Therapist
First, let's normalize your discomfort with ending your relationship with your therapist. Recognizing what feels off takes time, as does making the decision to move on. Goodbyes are challenging and often bring up painful emotions tied to past experiences.
Second, consider sharing feedback with your therapist on what you wish could be different. Notice how they react.
Third, decide how you'd like to move forward. Want to find a new therapist with a different therapeutic approach, specialty, or demographic background? Need someone closer or at a more sustainable time slot? Would you like to take a break, or are you finding it difficult to think of more things to discuss in session?
Lastly, remember therapy shouldn't last forever, and naturally includes a termination stage that also provides therapeutic value. Endings often mean new beginnings, and here's an opportunity to make goodbyes a more positive experience for you. Ending things on good terms takes courage and tact, and like most things, practice makes perfect.