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Page Contents: When and how to end psychotherapy.                    

 

I am a 45 year old female who has been in psychotherapy with a male psychiatrist for about 20 months. I was depressed, suicidal and addicted to drugs when I began seeing him and the process has been very intense. I’ve worked through powerful transference feelings for him of love, hate and terror. He has handled all this well and helped me to understand that I was transferring feelings toward him that I suppressed as an abused and neglected child. In recent weeks I have been feeling much better and our meetings have been less emotional and intense, though I feel I’m still getting a lot out of psychotherapy and I still feel dependent on him. But he has begun to ask me what our goals are now and what work we still have to do. I told him that I never came to psychotherapy with the intent to work on things, but just came because I felt I needed to see him and I still feel that way. He got annoyed and said that’s not a reason to continue and if the only problem in my life is my dependence on him, then we should cut back from once a week to every other week. He told me he really wants me to think about what we’re working on before our next session and I feel distraught over this. I never saw psychotherapy as work, but just as this overwhelming emotional process that I was caught up in. If work happened, it just did because I made myself so vulnerable to him.
 
I’m thinking maybe I need to work on ending psychotherapy, saying goodbye to him. But this thought makes me unbearably sad. I don’t know what to tell him and hope you might have some advice about when and how to end.

 
Psychotherapy is not just a matter of healing the past; psychotherapy is also a matter of facing the future.

Now, if you are no longer “depressed, suicidal, and addicted to drugs,” then you have done some very good work already. So, given all that you have accomplished, what work remains? Your future.

You can easily neglect your future, though, by focusing too much on the satisfactions of the present.

For example, a young child could become so dependent on her parents’ protection that she hesitates to separate from her mother or father in order to start exploring the world. This separation anxiety can even cause developmental delays in a child.

Well, the transference feelings a person experiences in psychotherapy are very similar to a child’s feelings of attachment for a parent. But, just as a child’s social and psychological development will suffer if the child clings dependently to parental protection, you cannot attain a healthy future if you cling to the present satisfaction of your transference feelings.

Like parental love, which, in a healthy family, is a means to a child’s independence—and to the child’s ability to perform productive work in the world—transference should be understood as a means to an end. Through transference you heal the past so as to face the future.

Your remaining work, therefore, is to dissolve the transference bond so that, functioning independently from your psychotherapist, you can take up your future work in the world with courage and honesty.

Remember, you were depressed, suicidal, and addicted to drugs because you didn’t receive from your parents the love and protection you needed, and so, in your fear and anger, you got stuck in feelings of victimization and never “grew up.” Now, having experienced the guidance and protection of psychotherapy, you have permission grow up and step into the work of your future.

 


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Raymond Lloyd Richmond, Ph.D.
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