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.

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. 

Ever since I can remember I have had major issues with food.  This was not a problem till I was ten and my mother told me I was going on a diet.  I promptly went to the shops and bought a bag of lollies.

By the time I was fifteen I was medically obese, then I discovered bulimia for a short while.  At 22 I revisited bulimia with its partner in crime laxatives, lost and regained half my body weight within two years.  I went up and down for the next twelve years and developed type 2 diabetes.  Then the lap band was invented and over the next ten years had two lap bands installed, followed by numerous cosmetic surgeries, and two lap bands removed due to slippage and erosion.

This was followed by several hospital stays for abdominal pain resulting in a small bowel obstruction operation.  My pancreas died completely and I was now insulin dependent and whenever I moved my insides swirled around like a sack of goldfish and I regained back half my body weight.

My therapist sent me a text message a few weeks ago on the morning of my therapy.  Would I like to go for a walk with her?  Instead of sitting in her office and trying to find a logical, rational solution to my problems, would I like to go for a walk around the local park?  She had been trying to get me to exercise for many years and finally I was walking on my own but I’d lost some of that motivation recently and was having difficulty finding it again.

Many years ago this offer would have sent me into a transference psychosis tailspin with its endless possibilities of real love and a post-therapy relationship, but with a lot of water under the therapeutic bridge she understood me well enough to know I would now be able to make creative symbolic meaning out of it, rather than a literal one. 

When you trip over and hurt yourself the narcissistic mother will sneer in a condescending voice, “Get up, you’re embarrassing me,” and the therapist would say in a tender dulcet tone, “Have you hurt yourself, can I give you a hand?”

While it’s a no-brainer that many people seek therapy for childhood psychological injuries, what is it about therapy that actually heals?  What therapy works best, CBT, DBT, Gestalt, REBT or supportive psychotherapy?  Do the therapist’s educational qualifications have any bearing on outcome?  Do male or female therapists heal clients quicker?  Or is it the person of the therapist who connects with the client that has the ultimate healing power?

Transference can be the duct tape that binds the psychotherapy universe together.

One of the interpretations of my mostly positive, idealizing transference was to use my therapist as a role model. This is similar to Social Learning Theory where people can learn new behavior through reinforcement, punishment and observational learning and are then more likely to model, imitate, and adopt the behavior themselves. This occurs through four stages; close contact, imitation of superiors, understanding of concepts and role model behaviour.

Albert Bandura, expanding on this theory, studied patterns of behaviour associated with aggression by conducting the Bobo doll experiment in 1961. Seventy-two 3-6 year olds were divided into two groups. Two thirds were placed in a room with an adult and Bobo the doll where the adult hit and kicked the doll and the other third was placed in a control group. In a nutshell, Bandura found that the children exposed to the aggressive model were more likely to act out in physically aggressive ways than those who were not exposed to the aggressive model.

So if in therapy I am exposed to someone who deals with life by displaying good manners and an unruffled aura in a situation where appalling manners and a decidedly undignified process of behaviour is apparent; then by the wisdom of social learning theory, good role model behaviour by my therapist will begat new thought processes, schemas, beliefs and behavioural patterns by me, the emotionally-dysregulated client. A classic case of monkey see, monkey do.

For me, mirroring this process was at first largely unconscious in the real world until I related the stories in therapy and realised I had well and truly kept my wits and composure about me. Similar situations would then compound on themselves. As well my therapist would tell me personal stories of adverse situations where clarity and coolheadedness were required. In a similar situation where I would explode, burn my bridges and later have serious regrets, she would be able to stay calm, centred and (most importantly) in control – move on, regret nothing and remain the person she always was.

When I deliberately started to imitate her behaviour, after a …