I have had this issue specifically with my therapist but not with other key people in my life. I knew, for example, that my parents were there and continued to love me even when we were apart. But for me the therapeutic relationship felt very magical and unreal.

In a sense, the relationship does cease to exist out of session. My T allowed limited out of session contact (I would write rambling emails, she would write terse replies and on a few occasions we had short phone calls or unplanned extra sessions). This helped me trust her as a compassionate human but did not help with object permanence because even though it was “proof” that she existed out of session, the problem was not really a cognitive one.

I suspect that’s why the voicemails and transitional objects and all that don’t help you the way they’d help a child, Scarlet. For a child it’s both emotional and cognitive: they really don’t know for sure that what they can’t see continues to exist and this causes them distress. You know cognitively that your T exists but you nevertheless feel the distress from a much younger place within yourself.

My suggestion would be to shift away from thinking of the therapist as your center of comfort and security (ie. trying to make her permanent) but concentrate on making a place of comfort and security within yourself. That way, when you need comfort, your instinct will be to go to the place you’ve built within rather than trying to find or strengthen your therapist‘s presence in her absence.

There are lots of ways to do this. I like analogy and imagery so visualizing a metaphor for what I need can be helpful: a deep well/aquifer of strength/peace (“dig deep”) or a tree with deep roots (“connected, resilient”). Also sometimes I need to literally just giving myself what I need: food, rest, a heating pad, some time outside. If you feel cared-for or soothed in session, name it and notice how it feels and what is making you feel that way. That feeling is there ready to be elicited from within you. It belongs to you. You can learn to do that for yourself.