Termination phase of therapy

Poppy2014

Poppy2014

Well-known member
Joined
Jun 16, 2015
Messages
650
Location
yorkshire
#1
Hi, wanted to keep this separate from my main posts as its general advice I'm looking for.
I'm having Cognitive analytical therapy for BPD which has in the main been really good, it is supposed to be 16-24 sessions for BPD but I will have had 48 sessions which is not unheard of but rare.
We are now in the termination phase, endings are a very difficult phase for me as I've had 2 abrupt endings that weren't my choice. Consequently it didn't take long for the symptoms to come back and problems both personally and work wise to crop up

I've discovered a problem... I don't want to finish therapy,
I'm scared that even if we have a controlled finish things will still go wrong and I'll have nowhere to go.
I'm angry at S because he told me 48 sessions and I'd have to finish. The rational, logical, grown up part of me understands and is in total agreement, the newly minted child with emotional language part of my is having a proper kicking and screaming session like a 2 year old.

S knows I don't want to finish, which is why we are devoting 8 sessions to giving it the best shot we can.
S is now on leave for 2 weeks so when I see him next it will have been 3 weeks.

I'm doing what I do best, researching the hell out of endings in therapy. There is a lot of good stuff there until you add BPD then it's horrific. Now I'm at the oh my God stage, am I really that bad..because I can see a lot of things I've done in therapy on those pages.

What I've realised is I'm attached to S, not in a romantic, erotic or stalkerish sort of way, but as the voice of reason...
He is the voice I need to hear when I'm not getting it, he's the one I want to talk things through when I'm going off or when I've gone off. He's the one I know when I say x to he will be logical and allow me to talk y and come to a reasoned decision. He is my anchor point at the start of the week, I suppose he is the only thing I can say will happen so he is my stabiliser.

Now I know he's right and this has to stop, he has been clear when he told me why, he is not a long term therapist, that is out of his competency framework, but he has also said I would benefit if I saw him every week until I said stop. I know what he means and in no way was that to confuse me or give mixed messages, there is a lot more we can discuss, but it doesn't fit with the CAT model.
He has said this will not be the last time I access therapy, just not with him, he recommends shopping round for therapy that fits what you need at the time and has recommended a book about the different types of therapy.

So after a long winded approach, has anyone successfully ended therapy when they didn't feel ready, how do I start detaching from S and become more independent, and how do I switch his using him for stability into being by myself?
 
Poopy Doll

Poopy Doll

Well-known member
Joined
Jun 13, 2015
Messages
11,439
Location
Fort Lauderdale, Florida, USA
#2
Poppy, attachments are hard to deal with in many facets of life, but it's particularly poignant with a beloved therapist. I am no expert on detachment. I have never in my life, in thirty years, been so close to a therapist. I think you are very fortunate to have had such a relationship with a counselor. That is a very precious experience. And then it's time to move on to the next phase in life. Embrace it and accept it, Poppy. It will be a good thing. If certain triggers happen, it's an opportunity to grow past those triggers.

I am currently dealing daily with a shocking sudden detachment from a couple family members; so all the old family patterns have been trotted out with force. I just have to go through it. I feel panicky for a moment and then I realize it's the pattern; being rejected by family members who are the origin of the pattern is another "opportunity"; oh,yay.

I wish you the very best. :)
 
AliceinWonderland

AliceinWonderland

Well-known member
Admin
Moderator
Joined
Jan 25, 2012
Messages
9,810
Location
UK
#3
So after a long winded approach, has anyone successfully ended therapy when they didn't feel ready, how do I start detaching from S and become more independent, and how do I switch his using him for stability into being by myself?
Yes, I know what you mean about your therapist's being the voice you want to hear, and the person you want to talk things through with. You can't imagine that you will ever have the same experience again (in real life, or with another therapist), because they are the one that understands you so well.

Yes, I have BPD traits in the mix too, which makes it much worse dealing with endings and feelings of abandonment, and the more intense emotions that BPD can involve. It's good to recognise you're having those emotions of anger etc though, and to be able to express that you are to your therapist so they can be explored.

I've had two different experiences of ending therapy, one went well and one didn't. The one that didn't, I knew therapy hadn't achieved what it needed to (by a long way, it had in fact made things worse), and I found the ending impossible to face, because I was so disappointed and let down that it hadn't provided any solutions, it had in fact only raked things up. So instead of facing the ending, I left before the course of sessions was ended. I couldn't face it, knowing it hadn't helped and wasn't going to help. Yours I think has helped, so it's not like you don't want it to end because you're still waiting and hoping for it to begin helping you. So not really the same, although I did like the therapist a lot, and initially had high hopes she was going to help solve a lot of my issues. It was still a complicated situation of attachment to disentangle from to some extent, but not in the sense of not knowing how I'd cope alone without her.

The one that ended well, the ending was really well managed by my therapist, and it sounds like yours is planning to do that too. I knew it had to end, sort of my choice (I had to move away from the area, but wouldn't have ended therapy otherwise), and whilst I still thought there was a lot of work to do, I also felt like a lot had been addressed and achieved. I was very attached to the therapist, and wondered how I'd ever manage without her input, and without being able to talk things over with her, I couldn't imagine not seeing her any longer, what that would be like. But because the ending was tackled slowly and thoroughly, with the last few sessions getting further and further apart, so that I began to cope with longer gaps between seeing her, that eased me in more gently to stopping (I wonder if yours would be able to do that, I found it really helpful?). I guess I was able to internalise to some extent the perspective she'd given me, so that I could carry it with me when I stopped seeing her. What I'd gained and learnt, and the ways I'd be able to change my thinking and how I felt, didn't immediately desert me when therapy ended, I was able to carry it with me (not totally, and at times I struggled to much at all, but it's a two steps forward, one step back process I think).

What you wrote made me think about transitional objects that therapists sometimes give their clients when there is a break in therapy, like an attractive pebble or similar, that the patient can hold when they need to remember that the therapist is there for them even when they aren't able to see them. To remind them of, and to affirm, the connection they have between them. Maybe you've come across this in the reading you've done? I wondered if something like this could help with the ending of therapy also? Something physical to take away with you to to remind you of your therapist and their input, of the work you've done and what has been achieved, and that you will always be able to carry that with you, that it's now internalised inside you, even after you've ended therapy?

What he said about this not being the last time you will access therapy, bear that in mind too. I've had more therapy after the two endings I described above. It's built on those two previous experiences. I'm in therapy now, and have tried to end it prematurely on a couple of occasions, and realised I wasn't ready, so I still have this ending to face at some point, probably in the not too distant future.

I struggle with abandonment issues, so I find endings hard. I can feel rejected even if the adult part of my brain knows that logically it's not about the therapist abandoning or rejecting me, it's just what has to happen. Good luck with the ending, I hope the next few weeks go well. Try to be as open as you can about yours fears and concerns about ending, I think it's important you feel your therapist understands how it affects you and how you're feeling, what emotions it brings up for you. If therapy's been good I think you always carry the effects of it with you :peace:
 
Last edited:
Poppy2014

Poppy2014

Well-known member
Joined
Jun 16, 2015
Messages
650
Location
yorkshire
#4
Thank you so much for your replies, AliceinWonderland yours reminds me so much of what I'm going through right now.
In some ways I'm more lucky than most, inasmuch as I have contact with mental health nurses at work, I have discussed attachment and transference with one of them I trust and he recommended some research which I have read and re-read.

Part of CAT therapy involves drawing maps of feelings and states which are my seperate personalities and what happens to me when I lose control. I have used this to produce another map covering the states I'm in when we talk about endings including the feelings and thoughts that occur with each state. Then I've drawn what I where I want to be when we end and the language needed to move there.

One of the things S has always encouraged is for me to write to him, sometimes I read those letters other times I use them as a basis for our sessions.
CAT encourages both S and I to write a goodbye letter to each other, I've already wrote mine as it goes with my maps. I will take it to our next session on the 4th as even though it's a goodbye letter there are things to work on in it which go along side the map. Hopefully both together will make this work.

Funny you should talk about transference objects, I have a pebble on which is written "courage" it was given to me at Christmas when therapy was at its most intense. I can use that as a daily reminder of the feelings associated with it.

Abandonment is the biggest fear of all, so I can understand a little of how you feel about your ending, I hope it goes smoothly and well for you, I think I'm going to ask about the graduated ending though and see what he thinks about that, I suspect it will be a no as we have up to 8 review appointments I can access in the next 2 years.

Again thank you, Poopydoll, I'm so sorry to hear you are having family problems, mine is the reason I'm in therapy,they do have a lot to answer for. I hope you manage to sort things out either with them or without them whichever is best for you xxx
 
Last edited:
AliceinWonderland

AliceinWonderland

Well-known member
Admin
Moderator
Joined
Jan 25, 2012
Messages
9,810
Location
UK
#5
I'm in therapy now, and have tried to end it prematurely on a couple of occasions, and realised I wasn't ready, so I still have this ending to face at some point, probably in the not too distant future.

I struggle with abandonment issues, so I find endings hard. I can feel rejected even if the adult part of my brain knows that logically it's not about the therapist abandoning or rejecting me, it's just what has to happen.
My therapist told me this week that she's leaving. I was not at all expecting this. We don't have many sessions left. I don't know how I feel. A bit numb and shell-shocked I think.

I wonder how things have gone for you Poppy, and whether you're still seeing your therapist, or has it ended now?

Edit: ah I see you have another thread 'not coping' where you talk about this.
 
Last edited: