I read the book about therapy by therapist Lillian Rubin, The Man with the Beautiful Voice, which someone here recommended, and was interested by her thoughts on what happens to therapy when a therapist goes away.

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A therapist's comings and goings can be a challenge for the patients, although one that I think is often vastly overstated. Indeed, I believe that therapists often encourage their patients to act out each time they go away because we're taught that's what to expect. In my more ungenerous moments about our profession and its rewards, I also think we get a certain amount of narcissistic gratification out of believing we're so central to our patients' lives that they're unable to manage without us and will, as we say to each other, "pay us back" for not being there.

The message we too often send, both verbally and nonverbally, therefore, is: I expect you to be upset and angry. We invite them to talk about it, to tell us how they feel; we assure them that anything they say is okay. And as with a child, if you expect untoward or regressive behavior, you'll get it. It takes a wise patient with a solid adult sense of self to be able to say, as one said to me years ago, "Why should I act like a child? Will it get you to stay?"

Certainly, most patients will miss their therapist when they're gone, since it isn't easy when the work is disrupted, whether for other professional obligations the therapist may have or a vacation. And it's useful to talk about those feelings both before and after the separation. But something different happens when that conversation takes place in the context of a therapist's attitude that says "I know this is hard for you but, as you already know, life's not always easy, or even fair."

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What do you think of that? Can the therapist overstate the case of his/her going away? Make the patient feel overly dependent or like it is a bigger deal than it really may be? Do any of you have therapists who expect acting out and angry behavior in response to an absence? And does that expectation increase the likelihood of the behavior?

This was very interesting to me, as the absences of my therapist are accepted by me as necessary, and I don't take them personally by getting angry, etc. I do miss him VERY MUCH when he's away and think of him often, but it is not traumatic for me nor does it make me angry. The hardest separation between my sessions was the longest one, between my first ever session and the second, and it lasted 1 month. I didn't get angry, but anxious that finally now that I had found someone I felt could help me, that we were never going to be able to connect again and do therapy together. I wonder if my accepting attitude toward my T's absences is because he never dwells on this or acts like I shouldn't be able to handle it. He very matter of factly says to me that he will be gone later this month (on vacation, to a meeting, or whatever), and there is the expectation that I will accept this graciously, as it is something that can't be changed. (Similarly, I don't expect him to get bent out of shape when I have to skip a week due to my own absence.) So I wonder if his matter of fact attitude provokes in me this matter of fact acceptance, as Rubin seems to suggest?