Whether you’re passionate about seeking help or dragging your feet at the behest of loved ones, getting yourself to a therapist’s couch is an accomplishment. Once you show up, you may experience a compatible patient/therapist match with a near-immediate comfort level. Or, it may take a bit of “therapist shopping” to find your match.
Either way, at some point, you will likely face a juncture in your therapeutic relationship at which it becomes time to have the dreaded “breakup” talk, which can require just as much, if not more, courage than that first five minutes in your therapist’s office.
Breaking up is hard to do and the decision to end a relationship can be even more fraught and confusing when “dumping” your therapist, the potential vessel of some of your innermost feelings. Perhaps your gut is sending signals just a few sessions in that the vibe is not quite right. Maybe you’re just not making progress, but you’ve grown so accustomed to the safety and reliability of that routine that it’s just hard to part ways. In the ideal scenario, you’ve made impressive progress and are ready to end therapy altogether.
No matter the circumstance, the topic of ending a relationship can feel awkward. It may be tempting to fade away by missing sessions. Some people expend precious time and funds stagnating in unproductive therapy, simply to avoid the awkward moment of confrontation.
My client, who I’ll refer to as Allison, and I spent an entire session devoted to practicing how to end her relationship with a psychiatrist I’ll call Dr. Persistent. When Allison began to suggest she meet with Dr. P monthly instead of weekly, Dr. P insisted that Allison was on the cusp of a therapeutic breakthrough. Allison noted she often felt judged in her sessions and was also concerned about the side effects of her medications. Dr. P reportedly minimized her experiences.
With some practice, Allison got used to the idea of telling Dr. P she would like to end their relationship - rather than simply suggesting it. Allison is now seeing a different psychiatrist on a monthly basis who is eager to hear her input.
Therapy is not cheap, time is at a premium, and if you’d be better off in a therapeutic relationship with someone else, it’s unquestionably worth refocusing your time and energy in experimenting with other clinicians, or different forms of therapy altogether. Here are some helpful strategies to navigate therapy decisions:
1. Remember why you're seeking therapy
Once you’ve established a comfortable rapport with your therapist, it can be easy to fall into a routine. Months, even years, might fly by before you realize you’re not making concrete changes. Ask yourself: Are you making progress on your therapy goals? Are you living a better life? If you’re not feeling like your life is changing, you might need to rethink the process. In my mind, the goal of therapy is not necessarily to find a great friend or sounding board, but to also work with someone to gain strategies to propel you forward. There are many options and types of therapy. Don’t feel discouraged – explore your options.
2. Speak up
A good therapist is not a mind reader. Let your therapist know what works and what doesn’t - it’s important to be your own advocate in therapy since you alone can speak to how therapy is impacting your quality of life. If you’re concerned that your therapist’s approach is not addressing your issues effectively, opening a dialogue about it will help you work together to retool the approach. Or, you may realize that finding a new therapist is the best solution.
3. Don’t be shy about money
If the cost of therapy is weighing so heavily on you that it’s causing you additional anxiety, it’s important to broach this topic with your therapist. Meaningful therapy is an investment - albeit one that shouldn't create financial turmoil. You might consider talking about reducing session frequency or finding a more affordable provider.
4. You come first
Relationships formed with a therapist can and should be quite intimate, and it’s understandable that you’d consider your therapist’s feelings as you might a friend’s feelings. Still, it’s important to remember that rapport and intimacy aside, you’re paying for a service, and your wellness must take precedence. While communicating your needs can and should be done gracefully, you are not responsible for “taking care of” your therapist, even if he or she might take offense or feel rejected. He or she was trained to weather the various negotiations that arise in patient/clinician dynamics, and your desire to move on is valid and par for the course
5. End well
Don’t slip away or shirk calls. Ending therapy can serve as an opportunity to gain closure, work on relapse prevention or gather referrals. If you feel like you haven’t gained from a therapist, you may accomplish something by having the courage to have a conversation about that. I often think final therapy sessions feel like graduations where we celebrate accomplishments. Ending a relationship well may influence how much benefit from the process.
Need to find a therapist? Here are some resources:
Jennifer Taitz is a licensed clinical psychologist based in New York City. She is the author of End Emotional Eating: Using Dialectical Behavior Therapy Skills to Cope with Difficult Emotions and Develop Healthy Relationship to Food. Visit her website drjennytaitz.com or find her on Facebook and Twitter to learn more.