At what point does a therapist decide to terminate a client because their relationship has broken down? Over the past three years writing my blog I have received many emails from therapy clients telling me that their therapists terminated them, either for no reason or for a small infraction within the relationship.

Are therapists being over-sensitive or are clients diagnosed with borderline personality disorder unaware of their own personal lack of empathy towards someone who is on their side? Being terminated for relationship issues with the therapist does not make sense to me. The entire reason we are in therapy is because we have huge external relationship problems and this plays out in the therapeutic relationship and the therapist should be aware of this.

The therapy “hour” is anywhere from 45 – 60 minutes, which is clearly not nearly enough time to arrive, get down and get dirty before you have to leave, half way through, without finishing what you started out and feeling like something has not been completed. The therapist might be left gasping and glowing with satisfaction, but essentially if this was sex you’d be faking your orgasm and walking out with your head held high and having to wait till next week when you get to do the same old frustrating exercise all over again.

If the session was 2 hours long, I might start to feel as though the earth had moved for me as well. It would be wonderful if you could just radiate in the afterglow of the warm therapeutic space that had been created by the two of you, but after 45 – 60 minutes it’s time for you to get out still feeling hot and bothered (and for the next client to come in cold) all the time brooding and ruminating that the earth might just move for them in a way it did not for you.

It used to be that if I ever ran into my therapist at a café, at the airport, in a restaurant, or walking down the street, I would have to walk out, catch a different plane, leave my meal or cross the street and get hit by a bus. She once said to me that I would have moved on when I could pass her in public, either wave or not wave, and my care factor would not be there.

So how do I avoid either the impending feeling of doom and chaos or the sheer guilty pleasure and excitement of seeing my therapist outside of therapy for free? I have had a mixed reaction on the handful of occasions I have seen her or her car out in the wide, wide world.

When therapy is over and you are healed to the best of your ability, is it time to mourn or celebrate the end of the therapeutic relationship?

Dear XXXXX,

I thought it was safe to let you know how I was doing. I thought it was safe to email you about what my thoughts were regarding brief psychosis –v- depression (which is something I have finally made sense of and wanted your opinion on because I trusted you). I told you what my current working life was like and I felt as though I got a rubber stamp response because nothing in your email referred specifically to what I had actually said or achieved.

In therapy once, you asked me to always let you know how I was doing because you didn’t want me to move on and disappear out of your therapy life. You also once told me you loved me and trusted me deeply and that you would never abandon me.

With those bold statements comes a considerable amount of post-therapy responsibility to clients, even to the most adjusted but vulnerable client who has left your therapy and your rooms. With that comes a duty of care to accept that sometimes the client who wants to move on feels much dissonance, ambivalence and an overwhelmingly disproportionate sense of obligation and responsibility to her former therapist to keep her informed lest she feels abandoned by her.

Ahh, the Erotic Transference!  The question is do we want to have sex with our therapist because of a deep-seated oedipal complex, primary attachment gone tragically awry, a pre-verbal object relationship that cannot be unified or do we simply want to shag an attractive, empathic person who sets our genitals on fire?

Much psychological literature is written by Sheldon Cooper types (The Big Bang Theory) who are socially autistic or have Asperger’s syndrome and are desperately trying to quantify the unquantifiable by using terms such as “erotic transference” instead of “lust or love” because by using wholly scientific terms it distances themselves from their own primal and lustful urges.  That is why Amy Farrah Fowler (Sheldon’s girlfriend) cannot understand these sinful longings she gets when she is around men.  It greatly distresses and frustrates her.

Admitting you have sexual feelings for your therapist to your therapist can create shame and disgust. We are all sexual beings, it’s how we relate beneath the superficial veneer of expected manners and mores of society. 

At what point in therapy should an experienced therapist tell a long-term client with a Borderline Personality Disorder diagnosis, in an unsolicited manner, that they love them?

This is what my therapist said at the last session I had with her.  I do love you.

It was a major catalyst, amongst other things, for my decision to leave therapy back in April.  Our email relationship limped along for few months until I finally pulled the pin.  That occurred this morning.

The overwhelming sense of freedom, relief and empowerment is tinged with much sadness, grief, loss and longing.  I loved her dearly and she said she loved me, but only in the context of a therapy client within her four walls.  It was not a marriage proposal and we are not going to walk off into the sunset and live happily ever after in a house with a white picket fence.

I can live with that.  Finally.

Ten years ago, I went to a David Cassidy concert in Perth and pressed myself up against the stage for him to come down and hold my hand, which he did.  But apparently I held on for so long he had to scream in my face, “LET GO!”

That was the best advice I have ever received.  I have finally taken David up on his offer and would like to take this opportunity to thank him for his insight and wisdom.  I have let go.  I have let go of all that emotional baggage I have been carrying around with me for nearly fifty years.

Imagine carrying fifty kilos of rubbish on your back, an amount that has accumulated with every year you have lived on this earth, then picture yourself dumping it forever down a deep, deep shaft.

After embracing mindfulness and acceptance I have done that and the feeling of freedom that entails is quite an intoxicating experience.  That is not to say my problems have vanished in a puff of blue smoke; quite the contrary, they are still there only now I have a different attitude towards them.  I am not carrying them on my back.  They appear to have taken on an amorphous, abstract quality whereby they exist somewhere in space and time but are no longer part of me.  They are a separate entity that has no power, no legitimacy and no control over my thoughts, feelings, actions and behaviours.

Emailing and texting your therapist can be (for some) more addictive than cigarettes, alcohol and drugs.  The reward neurotransmitter dopamine floods your brain and motivates you to do more of the same. This is the same neurotransmitter secreted when you snort cocaine.  Even a simple email exchange can do this for some.  It’s not what drug you take, it’s the effect that drug has on your brain.

Until recently I had full email privileges with my therapist which led to gross feelings of narcissistic entitlement.  I haven’t seen her in therapy since April and I still expected her to be available electronically 24/7.  I would get upset when she didn’t reply within 12 hours.  If she did not reply immediately, I would get rude and hostile and she would apologize.

This relationship was not healthy for either of us.  We were merged and sometimes not in a healthy, nurturing, supportive, way.  Partly because of her availability, I would lurch from one crisis to another expecting her to resolve my life with a few words on an electronic form of communication.  Eventually she emailed that this had to stop and that I could email her, not every day, but every once in a while, and not to expect an immediate reply because quite frankly she was feeling overwhelmed.  She also said I was welcome to come back to therapy any time I wanted to.

I was recently at a social function and eagerly went up to this woman I work with, touched her shoulder and said, “Hi, how are you?”  She stared at me, looked very uncomfortable and frantically searched around for either someone more interesting to talk to or someone to rescue her from me.

This is a woman I have found curt, abrupt, dismissive, snappy and abrasive in the past.  I have never had an interaction with her where I have left feeling as though a warm breeze has blown through me, but rather a cold, icy wind that has left my whole being feeling fractured and discombobulated.

I knew this and yet I still went up to talk to her because, as a chronic masochistic people-pleaser, I unfailingly seek approval and acceptance from totally wrong and inappropriate graceless women.  I cannot bear the pain of rejection and abandonment from anyone even though I did not like her and essentially had split her into the “bad” part of the good and bad.  I always had an intense negative emotional reaction to her, felt deflated, empty and questioned who I thought was, and after an interaction with her I wanted to throw myself off a cliff.