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.

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.

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.

Six years ago I was officially diagnosed by a psychiatrist in a psychiatric hospital as having…drum roll please…BORDERLINE PERSONALITY DISORDER.  He said it to me in the same way he would announce he had a plague of rats infest his kitchen, discovered I had a sexually transmitted disease or that he had just found out I supported Tea Party candidate Sarah Palin.  It was delivered with revulsion, disgust and contempt.

Today I proudly come out of the BPD closet and out myself as having one of the most reviled and hated personality disorders ever constructed by the most esteemed and eminent fundamentalist gentlemen writers of the Psychiatric Bible the DSM – Diagnostic and Statistical Manual.

When I am in my therapist’s office, there is a definite time warp happening where fifty minutes can feel like fifty seconds.   If you want to slow down this process, just do some exercise with them.  Especially if you loathe physical jerks and find that the time just drags on when you are walking, jogging, bike-riding, playing tennis, doing push-ups or going for the burn at aerobics.

This is where that most peculiar and oppositional phenomena known as therapy time-warp, the parallel universe of the perceptual fourth dimension of time and space between the rapture of therapy and the abomination of exercise, tend to even themselves out and you are finally able to experience what real time feels like in therapy.

When two people get thoroughly engaged in a conversation and it flows to the extent you can feel and see the sparks flying across in the space between them, time is lost forever in the moment.  If the conversation drags or is awkward and there is not enough connection, each second can drag like a two year old in the chocolate aisle at the supermarket.

Eight years ago, after many months of frantic searching, I finally found a photo of my therapist with her family on the internet.  I cut her face out and stuck it on her business card and carried it in my handbag.  Every so often, when I was feeling insecurely dependent, I would take it out and look at it until it became rather worn around the edges.  It was a great source of comfort to me and kept me connected with her through some very dark times.  She never knew about this.

Perhaps it would be a good idea, especially for therapists who conduct Dialectical Behaviour Therapy to have a business card with a photo – a professional one not a personal family photo.  This way clients do not have to ask, beg or grovel and debase themselves asking for a photo from their beloved but reluctant therapist, nor spend hours furtively searching on the internet for an illicit image of someone they are perhaps pathologically attached to.  When you have a legitimate source of something private the guilt and shame of dependency, something which regressed clients seem to feel a lot of, can disappear or at least lessen in intensity.

Death of a spouse, divorce, moving house and losing a job are four of some of the major most stressful incidents that could happen to you.  I’d like to add a fifth one; and that’s making the decision, or having the decision made for you, to leave your long-term therapist.

I don’t need my therapist anymore for therapy – or survival.  I am able to look after myself and be my own therapist.  I can survive in the big, wide world with all the tools and devices I have learned over the years, yet to move on from my therapist would leave a huge hole in my heart.

The more child-like and dependent I was the more I needed her to stay alive, but the more I grew up and matured in therapy the more I relied on myself and less on her.  It’s not about the therapy itself.  That is the giddy part, growing up and away and moving on.  One can only move on in therapy as one gets stronger and eventually that dependence is replaced with independence.  And as one gets stronger one naturally starts to separate, first at an unconscious level and then one becomes aware that the nature of your feelings are changing.

Letting go of the fantasy of a post-therapy relationship with your beloved therapist means you are ready to move on from the transference.  When your mind starts to shift from an enmeshed relationship with another to a singular meaningful relationship with yourself where the focus is now “me” and not “we” it signals a profound shift in cognitive thinking.

There is much self-examination and reflection and untold pain that comes with this.  Socrates said that the unexamined life is not worth living and I have explored every possible nook and cranny of my inner life.  Letting go of someone you love is the hardest part and this creates a vacuum which needs to be filled with something that is just as meaningful.  Never take a crippled person’s crutch away from them unless you have a replacement that is equally as effective.  But before you do that, you need to reach into all corners of transference options and the therapist who is willing to explore every aspect of your attachment to him/her and their own considerable counter-transference issues and/or attachment to you is doing themselves and their client a huge favour. 

I was in session last week with my emotionally and socially intelligent therapist learning important role-modelling and personal negotiation skills when my mobile phone started to ring.  I swore loudly, threw my arms in the air, jumped up, and raced out the door and into the courtyard.  I was expecting a phone call to tell me whether or not I had a much-wanted part-time job.

Only for me it wasn’t someone giving me potential employment – it was a life or death experience.  If I got the job I would be ecstatic and if I didn’t get the job I was going to throw myself under a train.  One would make me feel very important and the other would annihilate me.  If I didn’t get the job, I would just keep walking to my car, without explanation because the alternative was to tell my beloved therapist I had failed – yet again.   I just could not face that.  Ever.

Not that I overreact or anything.