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.

When Borderlines and Narcissists clash, it makes When Worlds Collide look like two butterflies locking wings together in a mid-air prang. As someone diagnosed with Borderline Personality Disorder I had the misfortune to run up against a Narcissistic Personality Disorder and I would describe the experience like running full speed, head first into a brick wall without a helmet.

For me, it is exceedingly rare to come under the microscopic scrutiny of a dangerous and mentally unhinged person who appears to be made out of concrete in such a manner that a nuclear bomb would be unable to dislodge their black and white thinking. For this person it was either night or day, there was no pearly pink twilight or early misty mornings.

This person was highly and appropriately right and I was incredibly stupid and wrong. I know this because it was hammered into my skull at every given opportunity.

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.

Over the years, I’ve been fired, resigned or walked out (before I was pushed) on more jobs than there are symptoms of Borderline Personality Disorder.  I never understood why this was happening to me and I always thought it was the company’s fault, the other employees fault or that the Universe hated me.

There was always a honeymoon period where I fitted in for a couple of months, then came unstuck when the first small drama occurred.  This was always followed by a huge behavioural reaction from me.  I had not learned how to accept the vagaries of how companies operated, the diverse range of personalities concerned and my own borderline reaction to real or perceived workplace situations.  I reacted before I reasoned.

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. 

My life started to give me much needed and valuable freedom of choice when I finally put major emotional, cognitive, behavioural and physical boundaries in place. Previous to that I was forever delving into people’s private lives, hemorrhaging at emotional paper cuts, having concrete, rigid and inflexible ideas on everything and having anger management issues at lampposts and letterboxes.

Other People’s Boundaries:  I used to think if you were my friend you would tell me everything about yourself simply because I had this uncontrollable urge to spill my guts to you.  Now I choose to tell certain people certain things in a certain way and when I get that warning signal in my gut, I know it is not a good idea to share that particular story.  I finally learned this from sharing a story I should have left well alone during a peer workers course I undertook for my employment.

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.