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When Psychotherapy Ends Prematurely

It is a regrettable thing, but a lot of psychotherapy and counselling ends prematurely.  

Sometimes there is a shared sense of regret that the work won’t be going further, a shared sense that a connection has been made which might be important for the client, but which for obscure and perhaps rather unconscious reasons will not be going any further at this time.

Both you and the client know that this is a premature ending and you both know there isn’t much you can do about that right now.  You can try to work with the ending that is being presented to you, but sometimes you can only do so much.

A decision to end has been made and it has to be accepted

A man comes to see me, he is in his 40s.  He is cramped by nervous anxiety. He has suffered with it for a long time, possibly, as I came to discover, he had suffered with it all of his life.  He is a sensitive man with a high capacity for empathy and connecting with others.

In sessions as he speaks he starts to become relieved, the tension falls from him.

Then, arriving for his fourth session he says he won’t be coming back.

I am sorry to hear the news but grateful that at least we have the whole session to discuss it. Much better than when someone tells me at the end of the session and I have no time to work with the shared knowledge of the ending.  Those can be unpleasant endings.

Today we have 50 minutes to talk about it.

What sort of ending is this?

His life has gone through patterns of stopping things that might be useful or that might be able to go somewhere. He tells me that he feels relieved and that he just wants to go and work in his garden for awhile.

I say: ‘It makes me think of a plant that needs potting on’. He likes the analogy. He agrees and recognises that he is choosing to keep himself in his place.

He can see that he has done it through his career.  He reels off examples of how he has left jobs when they have offered him promotions rather than staying and seeing what the new position would be like.

He can see that this is a pattern that he has been repeating all his life.  He thinks it may have started when he was a baby and his mother was expecting his younger brother. His mother became ill and she had to spend a good deal of the pregnancy in bed.

I have the sense that we are in the rather sad position of being able to acknowledge all of these things, recognising that a limiting pattern in is being self-imposed, while knowing that at this time there is nothing that can be done about it.  It has a somewhat tragic feel to it.  I put this to him.  He nods.

  • It seems that the best we can do is try to end this period of working together as well as we can.  I try to make sure that if he ever feels like speaking again he knows he is welcome to contact me.  He seems to take that idea on board.

Then the session comes to the end and we say goodbye.  I find it a rather sad experience.  It stays with me, I wonder what will stay with him.  I am left wondering if he will contact me again.

In my career I have found myself developing some rather positive connections (transferences) with people which remain in my mind.  Sometimes it is these kinds of brief encounters, of therapies that end prematurely, that provoke a powerful sense of connection and of an opportunity that was lost. 

Now when I think of gardening, the work that we began to do comes back to me.

When Psychotherapy Ends Prematurely


Toby Ingham

Toby Ingham is a psychoanalytic psychotherapist and supervisor based in High Wycombe in England. Toby works on both a short and long-term basis with people who are trying to work through a variety of situations. Sometimes these relate to a specific event such as CPTSD, bereavement, divorce or redundancy, sometimes relating to a more general problem or behavior. He blogs on a wide range of psychological themes.


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APA Reference
, . (2018). When Psychotherapy Ends Prematurely. Psych Central. Retrieved on July 24, 2019, from https://blogs.psychcentral.com/psychotherapy-matters/2018/11/when-psychotherapy-ends-prematurely/

 

Last updated: 11 Nov 2018
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