Unloading Your Therapist: Breaking Up is Hard to Do

Ending a relationship is difficult. Most of us have been on the receiving end of a relationship “break up” of some kind. We know that it doesn’t feel good. Indeed, we know that it can be taken as a rejection (and often that is exactly what it is). Nonetheless, that doesn’t stop some of the same people who decry the insensitivity of those who unceremoniously “dumped them” from doing the very same thing, in the very same way, when they wish to be free of seeing someone else ever again.

With that in mind, here are a few guidelines for thought and action, and some examples of what people do, when and if it comes time to end a relationship with a therapist. Today, I won’t be talking about the sense of loss or sadness that sometimes accompanies therapy’s end. I’ll leave that weighty topic to another time.

1. The “I’ll call you” strategy. Usually, this is delivered by phone message. The patient probably has an appointment with the therapist and cancels it, adding that he will call to reschedule. Experienced therapists know that many people will attempt to end the therapeutic relationship in this way. It avoids a face-to-face conversation which the patient might imagine as uncomfortable, and it avoids actually giving any reason for terminating therapy. It leaves the therapist a bit in the dark, not knowing whether the predicted call will ever come, and probably not knowing what the reason is for the decision to end treatment.

2. The “end of session” termination. Patients often wait until the end of the therapy session to say something of importance, in part because it is uncomfortable or they don’t want to discuss it in any detail, at least not yet. This method of termination has the advantage of being done face-to-face; what it doesn’t do is to allow the two parties to process the reasons for that decision and discuss any concerns. Without some time to talk, the therapist cannot be helpful to the soon-to-be-departed patient, or find out much about the client’s reasons for his decision. Without knowing what those reasons are, its hard for the therapist to learn from any mistakes he might have made, anything he did (or didn’t do) that made the patient uncomfortable, etc.

3. The “no-show” departure. Some individuals who are receiving counseling decide to end therapy by simply being absent from their next scheduled appointment. This is rude, of course, and also risks that the therapist will charge you for the time even though you didn’t come to his office (most therapists expect 24-48 hours notice of cancellation in order to relieve you of the obligation of payment).

4. The “nasty phone call” ending. While this is a rare event, sometimes people want to hurt the therapist because they believe that they have been hurt or neglected by him. They leave an angry phone message and avoid any chance for the therapist to find out why they are hurting, just as they make it impossible to come to a more amicable resolution of the issues at hand.

5. The “I need a break” message. It is, indeed, sometimes appropriate for patients to take a break from treatment. It can get too intense for some, who realize that taking a breather might be helpful. On other occasions, the complications of life outside of the counselor’s office make continued therapy difficult for the moment. However, when giving the message that you “need a break” is simply a way of leaving therapy, with no intention of return, it doesn’t allow for any closure to the relationship, or any of the benefits that such closure provides (which are described below).

6. The “best” way. Whether you have been seeing the therapist for a long time or a short one, the issue of termination is an important one. It is appropriate for you, even from the start of treatment, to ask how long it is expected to last. If you are finding counseling unsettling or unproductive at any point, it is best if you discuss your concerns with the therapist as they happen. Since many people who enter therapy have a hard time with being assertive and direct, it might well be tempting not to talk much about anything that you believe the therapist doesn’t want to hear, and simply to end the relationship unilaterally. Unfortunately, you and the therapist are short-changed if you do this.

Ideally, your concerns should be expressed early in a session, when there is sufficient time to talk about them. Be prepared for your therapist to ask you why you are thinking of ending treatment. You might be surprised that the therapist agrees with you. Alternatively, you might be persuaded if he makes a good case to continue for a while. But if you are certain that it is time to end things, be sure to hold your ground. A good counselor should accept this without trying to make you feel bad about your decision.

Once an understanding is reached about ending treatment, that doesn’t necessarily mean that it must end at precisely that moment. You and the therapist might decide to taper-off sessions or to have at least one additional session to sum up the history of your work together and to say “goodbye.”

There are several reasons for having just such a final session. First, it should allow the two of you to review what you have accomplished, how your life has changed, and what you have learned. Equally, if nothing or little of value has occurred, it can give you the chance to inform the therapist where treatment went wrong. Therapists should be grateful for this information since it allows them to learn, adapt, and improve so that they can help those patients who will follow you into their offices. And, a last session gives the therapist time to point out treatment alternatives or refer you to other available therapists who you might wish to consult.

Finally, a good therapist who has known you for a bit of time usually has some very nice things to say about you, about your courage, wit, grace, intelligence, and the guts it took to look your problems in the face and try to change your life. The last session also gives you a chance to say “thank you,” if that is something that you believe appropriate. The counselor will usually let you know that he would be grateful to hear from you again, just to know how you are doing. And, the door is almost always open if a return to therapy is required.

So, therapy, even when it wasn’t as helpful as you had hoped, can and should end with an expression of respect and good wishes for your future well-being. You will usually feel good about being direct in doing what you believe is in your interest, and having the self-confidence and respect to tell it to the therapist face-to-face. Your therapist will be grateful too, in almost all cases.

No losers here. Only winners.

26 thoughts on “Unloading Your Therapist: Breaking Up is Hard to Do

  1. Steen V. Mitchell

    3. The “no-show” departure. Some individuals who are receiving counseling decide to end therapy by simply being absent from their next scheduled appointment. This is rude, of course, and also risks that the therapist will charge you for the time even though you didn’t come to his office (most therapists expect 24-48 hours notice of cancellation in order to relieve you of the obligation of payment).

    rude? give me a break! this is a business relationship (at base). a no-show is simply lost revenue for the practitioner. the term “rude” implies that the therapist should/would take it personally. ethically-speaking a therapist might have the opportunity to reflect on *why* a patient would choose to no-show. jacques lacan, the french psychotherapist, pointed out that us psychotherapy modalities often included ego-strengthening as opposed to more self-reflective strategies. perhaps therapists could also use a good dose of self-reflection.

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    • I agree that a therapist does need to reflect on why a person might do this and whether he has contributed to whatever led up to this. But, I disagree that this is simply a business relationship, although certainly that is a part of the relationship. In any mutually respectful relationship, business or personal, I think that “the golden rule” is a good guide: if you wish others to treat you well, you should treat them well. More specifically, if you expect the therapist to cancel an appointment with you in advance, as I believe most patients would, then you (as the patient) should do so as well. Moreover, therapists generally are required to give people, in writing, a statement of how cancellations are handled. Thus, the patient has generally given his written affirmation of his understanding and agreement with what is expected concerning cancellations.

      Liked by 1 person

  2. “Today, I won’t be talking about the sense of loss or sadness that sometimes accompanies therapy’s end. I’ll leave that weighty topic to another time.”

    Would love your thoughts on the above mentioned “weighty topic”? Thanks.

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  3. Thank you for this insightful article. I’m faced with wanting to bail out of therapy, instead of staying the course and working through difficult emotions. I’ll stay and hopefully gain some understanding on why I want to bail when emotions get difficult.

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    • Brava! It takes courage to do what you are proposing. If your therapist is a good one, talking to him/her about your ambivalence might help in opening up the underlying difficult emotions. All the best!

      Liked by 1 person

  4. Thank you for your article. After 6 years of therapy and massive improvement and success I am ready to terminate therapy. I think I’ve considered all the strategies you’ve described from the “no-show” to the “I need a break”. Your article helped me decide to bring it up early on in my next session and create a plan for ending therapy over the next month.

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    • I’m very pleased to help. Endings are almost always difficult. I applaud you for facing this head-on. Thanks for letting me know.

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  5. “Without knowing what those reasons are, its hard for the therapist to learn from any mistakes he might have made, anything he did (or didn’t do) that made the patient uncomfortable, etc.”

    I am sorry but it is not the client’s job to educate the therapist about mistakes the therapist may have made. Therapists can be trusted to figure out their mistakes in supervision.

    “It leaves the therapist a bit in the dark, not knowing whether the predicted call will ever come, and probably not knowing what the reason is for the decision to end treatment.”

    Life is all about uncertainty…24/7. We all live with uncertainty whether we like it or not. And we all survive. No one is entitled to special treatment in the notification department – therapists included.

    “This method of termination has the advantage of being done face-to-face; what it doesn’t do is to allow the two parties to process the reasons for that decision and discuss any concerns.”

    Not everything in life needs to be processed and discussed. Where is the trust that life will be okay for both therapist and client no matter the method of termination? Who is to say that clients are not making the best decisions for themselves and / or learning valuable lessons for themselves when they leave therapy under not-so-ideal circumstances? Life is messy for sure and human beings are doing their best to cope at any given moment in time. How about honoring and celebrating that along with offering some loving-kindness and gentle encouragement from the heart?

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    • Thanks for your comment, Nicole. You’ve given me cause to take another look at something I wrote over six years ago. Sometimes I find I need to revise my thinking, sometimes not. In this case I still believe what I wrote has value. You are certainly right that the therapist is not entitled to special treatment and has the obligation to figure out what went wrong, even without hearing a direct recitation of the patient’s viewpoint. But the suggestions I’ve made apply to any relationship — a simple showing of respect between any two people who are trying to work together. Too often people in and out of therapy cannot be direct and instead use avoidant strategies that are hurtful to them. Yes, life is messy, but what is being celebrated here is, in your words, the “loving-kindness” that comes with showing respect. The therapist will survive well if he is already solid and thoughtful about his work, whatever the patient does. The real loser here is not he, but his (now former) patient, who does not discover that he can have a good ending and look the therapist in the eye while saying what is on his mind. As to trust that life will be OK, some people will be fine, some won’t. No, everything does not need to be processed. Too often, however, people flee the challenges that will return in other forms until finally they are faced. Meanwhile, until they are faced, the years go by and the same mistakes are made. The termination is a learning opportunity for both therapist and patient so that whatever those mistakes are, they can be solved sooner rather than later. Again, thanks for your comment.

      Liked by 1 person

      • The problem is that in your scenario – the client is somehow obligated to both take care of the therapist (so they know why the client is leaving) and pay for it. I see no need for me to pay to tell a therapist I am quitting.

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      • Were there no benefit to the patient (or the therapist’s other future patients) to be obtained by informing the counselor of your reason for departure, I’d be inclined to agree with you a bit more. We live in an interdependent world where we survive and prosper by working together. If you have information that might cause the counselor to do a better job with others, you will be helping them by telling him what he might have done better. As I’ve tried to say in the essay and my previous responses to some of the comments, this is not to take care of the therapist: he will care for himself. It is a matter of being a person who can deal with parting (in one of its forms) in the most straight forward, direct ways. Finally, if the cost is the only reason one might not do it, the patient could contact the therapist, let him know he’d like to discuss termination, and reach an agreement that this would be done without payment. Yes, some therapists would then say no, but not all. Much depends on the length of the relationship and whether you have benefited by it. I’d like to think that most of us who have been helped by another would want to say thanks. In any case, I’ll say thanks for your comment.

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  6. confusedsggirl

    Dear Dr. Gerald . Excellent article and website.! Thank you for the effort and contribution. I have book marked your site since I started therapy and It is always helpful to come back to read and reread the stuffs here.
    I have a question hopefully you can shed some insight. I am an Asian lady in mid 20s living in Singapore. Over the past half a year, I have been seeing a reputable Singapore registered psychodynamic therapist for some past issues including trauma, depression ,anxiety and relational difficulties. I have made quite some progress with the trauma no longer affecting me , depression lifted and gained some insights on my defense styles that caused the relational difficulties. Apart from an issue of self esteem which still needs work and a mild anxiety due to the unfulfilled feeling of not able to decide what is the thing I am most passionate about for my life, I have been feeling pretty okay at large. I just had a session with my therapist today. What I felt was that we don’t seem to have more stuff of the past to discuss . So during the session we have been talking about my aspiration to write a bit or best to start writing a blog. He even suggested that If I were to start a psychology related blog ( one niche I am interested), he can be an expert to contribute content or give talk. Being a trainer , college level lecturer and a relational coach that worked with many MNCs and government bodies, my therapist seemed to sound more like a coach to me now. He requested me to give him my writing during our next meeting which is 9 days from now on. The past nine month I have been resting and not working full time . My savings has been spent on the house I bought. For therapy, I have been paying my therapist in cash the full amount on my own. So my finances has been always quire tight with no excess money left for saving or non necessary purchases. Now I am looking forward to start a full time position in the next two-three month to lessen my stresses.

    My question is : Although I find my therapist’s coaching useful, I am not sure I should be seeing him at a frequency like 3-4 times a month. Is this an acceptable way of conducting the therapy session based on my therapist’s background ? He really feels like my life coach now.In an Asian culture, we don’t go to therapist for all our problems for a long duration because the culture is more efficiency focused and with no insurance to cover us. And my main issue now- continue to try to find the one thing I love doing for life will not take just months to realize and actualize. So when would be a good time for me to consider termination? My therapist has been encouraging me to depend on him and commending my courage to look for help from expert like him as I have always been the independent type of girl who shoulder all things on her own. I know even if I would to take a break from him . He always welcome me back to see him. Still, it is financially taxing to spend so much without knowing when will there be an end.
    I felt alone and slightly confused about the therapy work we do now. The most important thing for me is the long term value of the work we do. With regard to my situation, can you shed some insight, advices or opinion please. Thank you so much !

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    • First, congratulations on all you have already accomplished. It is entirely appropriate to raise the issue of therapeutic goals, frequency of sessions, the cost of treatment, etc. With respect to goals and finding a passionate direction for your life, one type of treatment you might want to examine is ACT (Acceptance and Commitment Therapy): https://contextualscience.org/act/ Best of luck.

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  7. Could you give me some advice? My therapist know that I have abandonment issues. Very strong. We had been together about one and a half years. She knew my diagnoses when we started. She said she would not abandon me. She was going to have a baby. She talked to me and said she would be going on maturnity leave for 2-3 months and she knew I would feel abandoned so she and I were going to talk about it and work on it so when she does leave I will be ok. Well a few days after that session she complusively and arubtly calls and tell me she is not going to be my therapy anymore. I asked if we could talk about it. She lashed out “NO”. I went into a spiral of feelings of abandment. Ended up in hospital. Tried to hang myself twice I became so sucidiual. Restraints had to be put on me and a code was called. All I could say through all the crying I was doing was “my therapist gave up on me”. I said that over and over and over. Today I am still struggling with that abandonment. I cannot trust another therapist, afraid whatever happened to cause my last therapy to abandon me the way she did, the new therapist will do the same. I don’t know what happened and I don’t won’t to do the same thing with this new therapy. I did not get closure. I feel I need closure to move on. My therapist was teaching me to not be compulsive when yet she did the same thing terminating the way she did. I cannot move forward without answers. What shall I do and how should my last therapist should have handled the situation. People are saying forget it get another therapist. It’s not that easy for me. I am afraid my new therapist will do the same thing.
    Thank you,
    Need Closure

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    • Mallory,

      First, I’m sorry to hear about the situation with your former therapist. Based only on what you said, her abrupt termination is difficult to understand. Psychologists (I don’t know her credentials) would normally terminate face-to-face, give reasons for so doing, and provide the patient with treatment alternatives. You’ve said you require closure, but that is something we do not always get in relationships, whether in therapy or out. Apparently you have some friends and received help when you were hospitalized. Since those are the people who know you best, a possible direction is to contact the hospital staff with whom you worked to see what alternatives or referrals they might provide to you. Of course, this will be risky, but most helping professionals would find a different way of ending the therapeutic relationship than the one you’ve described. Best of luck.

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  8. It is a business arrangement. I will quit however I feel most comfortable. The therapist can deal with their own therapist if it upsets them. I don’t need to pay one to tell the one I pay I am not coming back. I really think you people need to get over yourselves.

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    • drgeraldstein

      You are not alone in this opinion, but most patients would not be satisfied with the service they receive if the therapist treated them in an instrumental way, as some sort of cash cow and nothing more. Kindness, affection, concern, and civility are, in addition to the mercantile element, all involved when the relationship is functioning properly. A therapist’s education in grad school is not the same as that which he might receive in a business school. And, I suspect a “good” business man has goals for his interaction with his clients and his working life that include, but go beyond, financial enrichment. Those therapists who find themselves only thinking of fees and payments should get out of the field, as one cannot do good work with such an attitude. That said, thanks for reading and commenting. Best wishes.

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      • I absolutely agree-would not want to work with a therapist who truly feels only the business component. When I was in traditional psychoanalysis, my analyst loaned me a book about a certain kind of chemistry or “love” (book used the word love, but that can be misconstrued or highly charged). My concern is rather that I often feel patients/clients are held to a different standard from the therapist. As the client, I’m expected to be direct and straightforward (my nature, anyway). My current and prior therapists, however, seem not to have that same standard (assuming it’s something that need not be held back from the client). Clients are expected to own their anger and are challenged if anger comes out indirectly as attacks toward therapist. Therapist can disown anger by calling it frustration, vent by allowing it to come out indirectly toward client. If client challenges therapist, client is projecting. If client wants to discuss further, therapist can write it all off as thought distortions. All of these things may be true. But at some point, thr client and therapist BOTH need to have a voice and be heard. I think that, at least for me, this is where I can resonate with the comments re clients being able to leave the therapist with uncertainty, etc. as clients, we tolerate such experiences quite freduently, and not necessarily always because it is in the best interest of the therapy. At some point, it’s natural to feel that if we, the client paying for help are expected to live with such discomforts or lose such opportunities, then a paid, skilled, experienced therapist who has expected is to tolerate these things should be held to the same standard.

        I may be the only one who feels this way, but thought I’d mention in case. Clearly I’m struggling with some power imbalances in therapy right now, and that shows in my comments. 😊 I am truly grateful for the help I’ve received.

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  9. Your comment has helped me rethink my post a bit. While I still believe the parting I’ve described as an ideal is “best,” it is perhaps too much to ask of the patient on the weak side of the power imbalance. The risk of some sort of push-back from the therapist is there and the news of an unexpected departure by the client can touch on the therapist’s own insecurities and his investment in the treatment, even his financial incentive to keep the meetings going. I’m grateful for your point of view, Lauri, and have learned something from it.

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  10. Please could I ask for advice. I was in mostly twice a week therapy for nearly 14 years. I got more and more anxious in the last year of therapy because of issues going on and broke the boundaries by returning to the house straight after the sessions. I knew I was getting in a state. One day my therapist let me arrive for the session and said that we couldn’t continue because it was breaking boundaries. She hasn’t been in touch since. I feel heartbroken. She’s made me so ill, I can’t even explain. I’ve been frantically texting, ringing, writing, emailing. She isn’t replying. Is there anything us clients can do. I cannot cope with what’s happened. This happened about a month ago. I am heart broken.

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    • There is only limited advice I can give, Marie, but first let me say I’m sorry you have been hurt in this way. I’m not sure if I understand your description completely. Does your therapist work out of her home? Sounds like it, in which case the boundaries can already be blurry about her public and private space. In any case, there is little to be done but grieve the loss of this counselor. Although you may now be hesitant to try someone else, a therapist who does grief-work would be best. Time and a sympathetic ear gradually mends a broken heart.

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  11. Excellent article and I agree with you, Dr. Stein. From my own perspective, I feel the cruelest thing one can do to another, is to ghost someone, especially if that person reaches out to them. I am talking generally, and a sibiling did this to me, which was devastating. I have an excellent psychologist, and I admit I do feel emotionally connected to him. Why wouldn’t I as I bare my soul to him and he is very nice, supportive and helpful? I think it would be cruel of me to abruptly stop our therapy without an explanation. Maybe it because of my paraprofessional work, but I know that many professional and paraprofessional staff put a lot of effort, heart and soul into their work in helping their patients live productive lives. Just my opinion.

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    • Thanks, Nancy. Part of the abrupt departure concern in the therapist is that it suggests the person fleeing is still fleeing (if indeed that was a part of his history) and he is unintentionally offering evidence of his lack of change and the therapist’s lack of effect.

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  12. I have no reason to process (whatever the hell that means) anything with the therapist – I decided therapy was no longer useful and so I stopped. The therapist’s feelings are not my problem, and a therapist who thinks they are all that helpful in the first place probably needs a reality check

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