Am I ready to leave therapy?
August 20, 2009 8:09 AM   Subscribe

Am I ready to leave therapy? And if so, how do I do it?

I have been in talk therapy for the last 20 months. I entered when I was severely depressed due to a sudden breakup, and worked through the issues surrounding that and previous romantic relationships (I’m now in a very healthy committed relationship that will likely result in marriage). I’ve also worked through a lot of other stuff relating to my childhood and have developed much healthier boundaries with my mother and a more open and closer relationship with my father. I’ve enjoyed therapy, in the way you can enjoy something that’s sometimes really, really difficult and painful. I found it more helpful than I dreamed it could be, and I'm proud of myself for doing some really hard work. I like my therapist.

However, she’s been on vacation for two weeks, and I’ve felt SO FREE. I didn’t realize that I’d gotten to the point of kind of dredging up the same old situations over and over again and that it was starting to wear me out. During my therapist’s absence, I had a potentially very stressful visit from my mother and a continued stressful situation going on with my extended family, in which I’m sort of the one everyone else is leaning on. I handled both with a grace and strength that I wasn’t sure I possessed without having someone to talk it over with every week. I guess I sort of confirmed what I wasn’t sure I believed—that I don’t NEED therapy to handle my family anymore. I can do it on my own. I enjoyed the freedom of experiencing what was going on without analyzing it.

So am I ready to be done? I’m not sure—I’ve never left therapy before. How does it work? Do I just tell my therapist that I’m done, and that’s it? Do we schedule a termination date and work up to it? How do you say goodbye?

Obviously, I will discuss all of this with my therapist when she’s back next week, and I’m comfortable doing so, but I just wondered. It seems like everyone I know in therapy goes for years and years and years and I don’t really want that. I’m totally open to going back if I feel like I need it, or if my life changes and I get depressed again, or for pre-marital or marriage counseling or for any other reason where it seems like it would be helpful. But for now, I’d like to experience more of this freedom of allowing myself to experience and be, without being compelled to compare everything to my childhood and figure out what it means or how I feel about it.

Any advice or experience from therapists or people in my situation is much appreciated.
posted by anonymous to Human Relations (17 answers total) 5 users marked this as a favorite
I haven't been in your shoes, but I have watched a dear friend develop what looks like a very healthy habiit of, after leaving a regular on-going therapy situation , being willing to go in on an as-needed basis when crises arise. Maybe once or twice a year, this friend ends up seeing his old therapist to sort out some clear objective (how to handle a particularly stressful work situation, etc.) without the open-endedness of their original working relationship. It sounds like you're ready for a similar arrangement.
posted by Meg_Murry at 8:20 AM on August 20, 2009 [2 favorites]

It sounds like since you're leaving the door open to "I know I can look you back up if I feel like I need it," that you're in a good position to check out now. There may be a slight chance that your therapist may want one more session, as a wrapup, but it sounds like you are in a good place.
posted by EmpressCallipygos at 8:21 AM on August 20, 2009

I totally think you can take a break from therapy at any point, and often times it is good to do let things settle. Now that you have an ongoing relationship with your therapist, it would be a comfortable transition if you wanted to start back up again. I think sometimes things come to their natural stopping point. Therapy is supposed to really be for you; there are no "shoulds".
posted by Rocket26 at 8:21 AM on August 20, 2009

I was in the exact same situation as you a couple of years ago. Had a rough few months exacerbated by old family issues, went into regular talk therapy supplemented by antidepressants for a little over a year, and then suddenly felt like I was ready to move on.

I ended up just not rescheduling an appointment I had to miss. No goodbye to my (excellent) therapist or anything. While I don't regret stopping therapy, I do regret not having that conversation with her-- I know she would have been supportive, and I'm sure your therapist will be too.

I would bring it up at the beginning of your next session. Your therapist might suggest that you come in a few more times or not, depending on how you've been doing in sessions lately and how confident you seem about stopping-- but whether you go for 3 more sessions or none is totally up to you.

And congrats on getting to this point; I know from experience that it feels really good.
posted by oinopaponton at 8:29 AM on August 20, 2009

It sounds like you're done. Congratulations!

When I've ended therapy, I usually do the "let's go from weekly to semi-weekly/monthly" thing. I've gone from weekly to monthly to as-needed with therapists, and that's always worked well.
posted by rtha at 9:06 AM on August 20, 2009

Obviously, as you said, you need to talk about it with the therapist. Tell her that you've had such good experiences in the past weeks, and that you are wondering about termination, and feel you might be ready. There should be a proper and planned end to therapy, not just an abrupt stop, and your therapist will work to make it happen that way, so please don't avoid it! In the long run, it will benefit you and honor the time you spent working with this therapist, and she will probably tell you lots of important, encouraging things at that closure session, so it would be silly to miss out on that. :)

Also, consider what goals you had going in, and whether you feel you have met them--share your thoughts with her about having met your goals. Go over the goals with her, and ask her what progress and resolution she has seen. It could be that you're feeling burned out from the emotional intensity of your therapy, and if there are some goals that have not been met, then maybe a short break from it would be something to talk about, with the intention of restarting at some point, once you've been able to get some distance from that intensity. If you feel like things are truly resolved for you at this moment, tell her. She will probably have some recommendations about what she thinks is appropriate for your care right now, but ultimately it is your decision. So without worrying about her reactions or feelings or editing yourself to make it sound softer or anything like that (because this is unnecessary to do with a therapist!), tell her honestly what you wrote here.
posted by so_gracefully at 9:17 AM on August 20, 2009

Your therapist is only paid when you buy her time. On that basis, she has a vested interest in getting a paying customer to come back. I don't think you'll ever find a therapist who suggests you just stop coming. So if you're done, just thank her and cancel your next appointment, or don't make any more.

Your sessions are only useful when you're interested, and there's no reason to buy a service you don't need. So if you're done (and it sounds like you're done - unless you had your post crafted by a professional who is trying to convince us you're done - you sound like you've got coping skills that are better than 95% of folks out there) make it final. You could leave your therapist a note, or go to one more session, just to let her know you have benefitted greatly from your Tx and will call her if you need some acute Tx.
posted by valentinepig at 9:27 AM on August 20, 2009

I understand your assumptions, but they are not correct. It would be unethical for a therapist to act that way.

I've had therapists suggest the step down process to me in the past when they realized I was growing more independent.
posted by Librarygeek at 9:32 AM on August 20, 2009 [2 favorites]

This four-part series of articles offers some detailed thoughts about the process of termination and how to go about it: Terminating Therapy.
posted by Dixon Ticonderoga at 9:35 AM on August 20, 2009 [1 favorite]

I don't think you'll ever find a therapist who suggests you just stop coming.

Pretty much all of my therapists have suggested exactly this, at pretty much the same time that I'd come to the same conclusion.
posted by rtha at 10:23 AM on August 20, 2009 [2 favorites]

I kind of think that you answered your own question. If you find that you feel better because you're not going to therapy, I'd say that you should follow your nose. If you start feeling really bad, you can go back.
posted by Citrus at 10:28 AM on August 20, 2009

I don't think you'll ever find a therapist who suggests you just stop coming.

Every therapist I've ever gone to has made a point of letting me know that the end goal of therapy is to get to the point where I don't need therapy anymore.
posted by xingcat at 10:48 AM on August 20, 2009 [1 favorite]

valentinepig, that's dead wrong in my experience, and in the experience of everyone I know who's gone to therapy -- in fact, I just ended things with my therapist this week for the same reasons the OP mentioned, and it was partly my therapist's idea.

OP, seriously, I just did this three days ago. I stepped down to bi-weekly sessions a few months ago due to financial constraints, but for the past few sessions I've been feeling like I didn't really need to be there -- we've dealt with the trigger issue that got me into therapy in the first place, we've dealt with the underlying issues, I have new coping skills, I've been in triggering situations lately and have handled them really well, blah blah blah. All the same things you're going through right now, basically. I brought this up to my therapist at the beginning of this week's session, and he told me that right before I walked into his office that day he'd been thinking pretty much the same things I was. We went over my treatment plan and various goals we'd set up, and how I feel about my progress with those goals, and what my coping mechanisms are for dealing with stress and social anxiety and blah blah redacted for interweb privacy blah. Long story short, we agreed that a transition out of therapy over a few sessions wasn't really necessary for me, since I'd already cut back to every other week, and that we could just end things with that session. Of course I am welcome to go back to him anytime I want for either an office visit or a phone session, whether I need to see him for several sessions or just an "emotional tune-up".
(One thing I didn't expect was the slightly melancholy feeling I got when I left his office -- honestly it felt a bit like high school graduation. Bittersweet, you know? We did a lot of hard work together and I feel like a whole new person going out into the world. It's a weird feeling, but in a good way. Be prepared for that.)

This is something your therapist has gone through countless times with other clients, and I'm sure she can help you end your sessions any way you see fit, whether you want to just stop going or if you want to slowly transition out. And I'm sure if you needed to go back to her for a few sessions, she would be open to the idea.

Good luck, and congratulations. :)
posted by palomar at 11:10 AM on August 20, 2009 [1 favorite]

Well, don't wanna beat a dead horse (not that you're the dead horse here - valentinepig), but...

the therapist is there to (IMHO) guide you through decisions where you may have difficulty understanding "what is behind" motives, beliefs, or just plain "thoughts" that we may have... always holding open that the possibility exists that "a cigar is just a cigar" or, in this case, that you may want to "quit" or trail off therapy simply because its utility/ usefulness has begun to wane. The thing (in this case) that a therapist may be able to help you tease out is whether there are other "reasons" that you're deciding that you're "cured" and no longer need this.

A person may have deep unacknowledged problems with going to a therapist where at some level they feel "broken" as long as the are seeing one... and long for feeling "healthy." - just an oversimplification/ hyperbole for sake of illustrating reasons for discussing such a topic.

There certainly exist therapists (I would say "bad" therapists) who operate in a less than ethical space where there are always things to discuss/ reasons to keep seeing them... but most are truly devoted to assisting folks in choosing (for themselves) the path which is best for the patient. - probably already said by others already, but this is my take.
posted by Jiff_and_theChoosyMuthers at 11:33 AM on August 20, 2009

I don't think you'll ever find a therapist who suggests you just stop coming.

That hasn't been my experience—my therapist was really happy for me when I felt I didn't need to see her on a regular basis anymore. She agreed with me, and I haven't been back in a few months.

I don't know if you're saying this based on personal experience or just assuming, but it seems clear (based on several responses after your comment) that it's at least not always the case. Seems like it would be pretty unethical for a therapist to approach a patient in that way...
posted by darkshade at 6:28 PM on August 20, 2009 [1 favorite]

My therapist is of the opinion that just as it's a bad idea to go cold-turkey from antidepressants, it's a bad idea to go cold-turkey from therapy. However, despite valentinepig's cynical opinion of the motives of therapists in general, mine has been extremely supportive of my desire to taper down and eventually stop coming.

We've gone from weekly, to every other week, to monthly, and at this point I'm seeing her every six weeks. At each stage, I've been the one to suggest decreasing the frequency; I don't think she would consider it appropriate to tell me "You should be coming less frequently." I'm planning to stay with this schedule for a while, as my drug doc and I recently reduced my antidepressant dosage by half, and I think it's useful to keep checking in with my therapist about how I'm doing on the lower dose. Also, winter is coming, which has always been a difficult time for me. Come spring, I anticipate stopping sessions entirely, with the option of a periodic "tune-up" session of the sort Meg_Murry describes.

As others have said, a good therapist is interested in getting you capable to deal with life on your own. How you get there, and on what schedule, may vary.
posted by Lexica at 7:34 PM on August 20, 2009

You know when it's not a priority anymore.
That feeling of freeness - that's what it feels like to fly on your own. You can do it now! Feels good, huh? :)

I knew we had been definitely winding down for a few months, but a few weeks off in December confirmed my feeling. It was: I'm done, for now. We set up 3 more sessions, to wrap everything up, and that was that.

I have dealt with all kinds of things since then on my own - romantic breakup, new and stressful job, etc. but when my apartment got broken into recently, in circumstances that left me feeling pretty lost and confused, I contacted her and asked if we could have a one-time session to deal with the incident.

I think when it starts to occur to you "Is it time to leave?" it means it's time.
posted by Locochona at 7:03 PM on August 21, 2009

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