There’s a mysterious, somewhat strange-sounding convention in psychiatry, I think. I’m not sure. I’ve never imagined it would apply to me, so I’ve never bothered to investigate it.

I’ve steered far away from. It scares me.

Leaving therapy…

Here’s how it was explained to me at the Eating Disorders Outpatient program I just completed. And remember, an eating disorder is a psychiatric illness.

For a minimum of two years, I was told, I could not go back to see my social worker, dietician or any of the practitioners who helped me begin eating normally for the first time in my life.

A follow-up might be possible, but now I have a psychologist to help me.

I suspect psychiatrists work in similar ways. I don’t know…

Once you say good bye. Once you receive your psychiatric “seal of approval.” Once you have your psychotherapeutic “walking papers.” Once you leave, is that it?

Do you venture off into the world on your trembling feet, vulnerable, alone? Independent?  Do you never see your therapist again? Or at least for a minimum of two years? That never seemed to be the case with Dr. Bob. It seemed he would always be there for me.

There have been umpteen articles and books written on this, but I’ve never read or even glanced at them because I never thought I’d face this situation.

Since seeing Dr. Bob last week for the first time in 10 weeks, I’ve been thinking about this.

Is it possible for me to be okay without a psychiatrist?

Of course, abrupt endings to psychotherapeutic relations shouldn’t be abrupt, according to one article by PsychCentral CEO and Founder Dr. John Grohol at World of Psychology, his blog. He used the word Termination (oh, how I hate that word) and it’s is a long process. It is may not be an ultimate end either, as he writes:

Although the word suggests an ending, termination really is the start of a new beginning for you. You are once again on your own in the world without the comfortable and safe weekly check-in with your therapist. And while that initially may be a little scary or sad, it marks another stage or transition in your life that you can embrace if you choose.

As the old saying goes, all good things must come to an end, and that includes psychotherapy too. Rest assured, however, that if you need to return to therapy in the future, a good therapist will be waiting for you.”

Also, wrote Richard A. Friedman, MD, a professor of psychiatry at Weill Cornell Medical College, in a 2007 New York Times column titled How To Figure Out When Therapy Is Over, psychotherapists should aim to liberate their patients from the therapeutic relationship:

“With rare exceptions, the ultimate aim of all good psychotherapists is, well, to make themselves obsolete. After all, whatever drove you to therapy in the first place — depression, anxiety, relationship problems, you name it — the common goal of treatment is to feel and function better independent of your therapist.

To put it bluntly, good therapy is supposed to come to an end.

But when? And how is the patient to know? Is the criterion for termination “cure” or is it just feeling well enough to be able to call it a day and live with the inevitable limitations and problems we all have?

The term “cure,” I think, is illusory — even undesirable — because there will always be problems to repair. Having no problems is an unrealistic goal. It’s more important for patients to be able to deal with their problems and to handle adversity when it inevitably arises.”

In all my 52 years of psychotherapy, the subject of my leaving it never seriously occurred to me or any of my psychiatrists. How could there be an end of therapy for me? How could what’s intrinsically wrong with me ever be righted?

My mental illness was chronic, wasn’t it? Incurable. Or is it?

Dr. Bob shocked me last week during ~ my reunion~ when he remarked repeatedly on how “healthy, mentally” I seemed. “How well” I looked. He congratulated me on all the work I had done in his absence with my psychologist, Kim. He said he’d never seen me so well. He was visibly impressed.

Since then, thoughts of leaving therapy, ending my psychotherapy with him ~ the possibility of it ~ have trickled into my mind. Perhaps there may be a time when I won’t need or want to see Dr. Bob anymore.

Am I addicted to therapy? I don’t know.

In a New York Times August 2010 autobiographical piece, writer Daphne Merkin covered this prospect provocatively in her Sunday Magazine story My Life in Therapy. I explored it in a post here.

I told Dr. Bob last week that my therapy with Kim was slowing down now and I said I didn’t feel I needed to see him every week either. We made an appointment for three weeks and I told him how good it was to have him back on this side of the Atlantic.

In truth, there have been lengthy hiatuses in our therapy before.

But nothing like this…

I’m looking to exploring the idea of leaving therapy with him. Although I can’t believe I’m saying this.

I feel a little like Dorothy in The Wizard of Oz (1939 MGM film) when she grasped the unthinkable. “Toto, I’ve a feeling we’re not in Kansas any more.”

 

 


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    Last reviewed: 1 Apr 2012

APA Reference
Naiman, S. (2012). Is There An End In Sight? Part 2…. Psych Central. Retrieved on October 26, 2014, from http://blogs.psychcentral.com/coming-out-crazy/2012/04/is-there-an-end-in-sight-part-2/

 

 

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