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Friday, July 8, 2011

One Door Closes, Another Opens

The ending of therapy

"Writing a Good-Bye Letter to Your Therapist"

When I saw this phrase in the search words, it struck me as sad.  I felt sad when I read it.  But then I re-thought and realized it could mean a lot of things.  It could be a good thing:  Possibly it is that an individual has completed their therapy, reflected on what occurred there and wants to convey that to the therapist.  The other, unfortunate possibility might be that someone is terminating their therapy this way.

Ideally, the conclusion of therapy happens by mutual agreement and when the client feels resolved.  The therapist will begin noticing repeated sessions full of good reports from the client  and when the inevitable vicissitudes of life do appear, the client is matter-of-fact about them.  The client feels that they are at a kind of a resting place in their own process.  Or, conversely, they are confident, now that therapy has helped them over a hump too challenging to go through alone, that they will carry on in their growth process independently.
Ideally, this will all have been talked through between the client and the therapist.  One reason that this is important is that sometimes new work appears at this juncture; most commonly the patient realizes that past good-byes are re-emerging.  Some good-byes (maybe most) are not said well.  So many of us have so much trouble with this that we go to great lengths to avoid even recognizing, much less experiencing, a parting of ways.  One very common manner of avoidance is to initiate an argument because good-byes are so difficult that it is easier to part by stomping off in anger.  A good-bye like that can haunt a person for the rest of their life. 

Sometimes good-byes aren't planned; something changes unexpectedly and one finds themselves gone or, left.  Sometimes good-byes happen because one of the people in the relationship dies.  There may be a chance to say good-bye, in that case, or, there may not.  These losses may re-surface as the patient begins saying good-bye to their therapist and they may then decide that the opportunity for integrating those hurts has presented itself.
Ideally, the end of therapy can take as long as the patient needs.  It can cover a review of the presenting problem, the topics explored in the therapy process, the feelings in the relationship with the therapist, any unfinished business, and an outline of what the client will be working on themselves, in their own growth process, after the therapy ends.

Unfortunately, this doesn't always happen this way.  Sometimes something goes awry in the relationship but instead of discussing it with the therapist and thereby having the chance to resolve it, the client just quits.  Sometimes people stop because they feel very satisfied with what has gone on for them in therapy but don't feel that it is a real relationship, so, again, they stop abruptly.  This will sometimes happen with only a phone message.  Some therapists will call back and suggest at least saying good-bye in person.  But, most won't as therapists are not in the business of telling people what to do, nor of pursuing patients.  As the patient, it's your call. 
Terminating therapy without some sense of closure may just add another torn apart piece to the material of the patient's life.  I would encourage those of you who have reached the wonderful point of feeling you had a successful therapy experience and are ready to forgo your sessions, that you take full opportunity of the chance to say a conscious good-bye!  And then, celebrate---a good job, well done.

What are your thoughts about good-byes in therapy or otherwise?


  1. Lately I read a lot of people are writing a goodbye letter not as the only means of saying goodbye but as something they can write and hand to their therapist as part of a closing session; a way to get down what they want to say when they know emotion will overtake them and prevent them from saying what they need in those final moments. Makes a lot of sense in that respect

  2. Caz---excellent point and, a good suggestion.

  3. I was tired of my therapist's saracasm and lack of respect. On my last visit, I got p 5 minutes in, as she daydreamed and had that stupid look she had as she gazed down. I got up, all she said was 'do you want your money back?' I offered to come back the following week to re-cap everything, after 2 years of therapy. Then I called a day later wanting my money back and never wanted to look at her selfish face again. This happens too, sometimes the therapist is selfish, lazy, tired and irresponsible.

  4. Yes, Anonymous, it is sometimes the therapist's own fault when thing go wrong.

  5. My therapist is moving to another city next week. I have to say goodbye to her next Wednesday. Although I've already found a replacement I am profoundly sad. I didn't think it would hit me as hard as it has. I'm going to have to write a note to her. I'll never be able to say what I have to say without going to pieces and I don't want that to be her lasting image of me. Thank you for letting me know it's okay to write her a thank you.

  6. Anony. It's a coincidence that this actually also happened to me once. A chance to learn something about how to say good-bye. The good part is that it is a loving ending. When it happened to me, I designed a good-bye ritual: I brought a tea party to her office for she and I at our last session. It was a nice closure. (I will never forget her though)

  7. I am not looking for to the day when I have to say goodbye. I have had six therapists in the past and each has been beneficial in some way, but I haven't allowed myself to get emotionally intimate with them. With my current therapist, in the DBT setting I am very intimate with her. I know it will hurt like a freight train when saying goodbye and I know that I will be able to deal with it and be forever grateful for her help in my life. I would want to have a final goodbye session no matter how awkward it is. Thanks for the post. It made me feel sad, but in a good way : D.

    Loss is part of life, which means you should try to enjoy every moment.