Odd termination?

Sorry to hear that you´re in a similar situation. Did your T definately terminate you or is there a way to repair the relationship?

You wrote you wonder why he didn´t clarify, did you get a termination session or how was it done? Did you just get a short message and therefore you now lack an explanation?

What was the source to the conflict or ending of therapy?

Hi (((PaulaS)))...

Sudden termination absolutely sucks, and Ts seem to handle it SO badly. I've been through that with a couple Ts. One that I saw for a year, who sent me for a consultation and when I got diagnosed, told me that he didn't have experience with that issue, so couldn't see me anymore. Ouch.

From what you've said though... (see the quotes above)... it almost sounds like maybe something similar happened with you, and the T just did an AWFUL job of communicating it to you?

You mentioned a couple times that she thinks that the type of therapy she does isn't helpful to you. Do you know what type of therapy she does, if it has a special name? Some therapies, I *think* are actually not recommended for some patients - because they can make your issues worse (or, sometimes they just aren't seen as being effective for some problems).

If she thought that her type of therapy might not be helpful for you, or that it would make you worse (and assuming that is the only type of therapy she knows how to do) - she'd have to terminate. She's not ethically allowed to keep taking your money if she doesn't feel competent to help you with your issues.

It still absolutely sucks, either way. And not understanding why it happened sucks. And, well let's be honest, therapy just sucks anyway - so I don't know if this is at all helpful.

I think the best thing is trying to find a new T, and starting to untangle some of this. As others said, it might help if you give permission to new T to talk to old T, to at least get some answers and closure...

Good luck, and I am very sorry you're having to deal with this!
(((PaulaS)))

I agree with guilloche, that sudden termination absolutely sucks. I have been suddenly terminated twice.
I see your point, that you expected to work out the issues you had with your therapist.

I was angry at my current T once and wrote down all my misgivings, confusions and anger....took it into therapy...warned her that we had a big problem...then I read my letter to her. I cried through the whole thing. I was so upset, I was ready to quit therapy.

My T was understanding, kind and empathic. She didn't get mad at me. She didn't fire me, either. It turns out it was a misunderstanding.

I'm sorry your T didn't handle your issues better.

Sad to hear that you also experienced bad terminations. To be in therapy for that long, a whole year and then be terminated, I think it´s very strange that your T didn´t see his/her knowledge limitations much earlier on.

Yes, I think she was very vague and just said a few sentences around the actual cause for termination, now leaving me very frustrated and sad. She said that I should try psycho analysis instead but just out of the establishment that I would benefit from talking more freely.

As psycho analysis is in a way a more "extreme" form of therapy I think it should be far more entended reasons than that?

Yes, I also think that a termination is correct if it just depends on the treatment form but as I don´t think any more extreme changes had come to the surface I can´t really trust her with her judgement. I still feel that if the kind of therapy was that wrong, why couldn´t she notice much earlier?

It´s not about finding a new diagnosis, just that my T talked about the kind of therapy being wrong.

So what was the issue that gave you pause with this therapist anyway? What prompted the email and what required you to have to miss appointments to think it over? It seems to me that you wanted to terminate? Then the therapist did it and you were surprised?

Hellboy

It was a set of issues but nothing that I felt had to be the end to therapy which I also told my T. I don´t know why you say it seems like I wanted to terminate, in that case I wouldn´t write about it here, I would just move on.

The biggest error to the whole process what that my T wasn´t open to discuss and neither did she have an understanding about why I did as I did. As several people mentioned in here and that I also commented on earlier is that many T:s don´t see criticism as and end to therapy but to someting to explore.

As I didn´t get a proper termination session either, I think my T handled the situation very badly, me now feeling frustrated and bad.

But multiple people pointed out in this thread the offer your T gave you for a final session, and you chose not to accept your T's offer!

Are you suggesting it's okay for therapists to terminate clients because the T thinks the client wants to terminate (without getting confirmation), even if the client hasn't said that, and there is no discussion about what the client wants or why the client is struggling?

I thought the rules were
that if the T is struggling, they can terminate but must make plans for support to transition the client (and should make every effort to deal wtih their stuff)
the client can terminate anytime
most Ts prefer to have a termination meeting and request a client agree to that (but cannot demand)
If the T is unsure what the client wants, they clarify things, not assume.
Ts may inquire if the client is wanting to terminate - but not assume and then act on that. clients are inconsistent and emotional all the time. Ts are paid to help sort through it - terminating is not a real effective method.

Well, it wasn´t that easy, the offer for a final session was preceded by my T making up her mind to terminate without letting me know and I also contacted her both by e-mail and by phone and didn´t get any proper engagement in my person. She had several options to offer me some real termination, to show compassion and understanding but she didn´t. It wasn´t about me just not accepting a final session. If it had been a proper offer about sessions for termination, of course I would have want to participate.

Syra: I also want to know this and I feel exactly the same as you. Isn´t therapy about helping the client to figure things out and to work things out when it gets rough? I think it is. If the solution is to terminate when things get a bit tricky or hard in the work together with a client, I don´t think that T has the right spirit.

I agree.

I'm wondering how you see therapy as different - or not - from an intimate relationship, or a friendship, or even family. I might agree with you if the person involved was anyone but someone I pay to help me when I am confused and hurt. Do you think Ts have the same, or a higher standard before terminating a relationship.

It's a relationship with a professional helper. The rapport you share with them is the fundamental aspect to the therapy. They must maintain their therapeutic boundaries in order to remain effective as a therapist. You may feel otherwise toward them, but this is transference and that's okay, it's all part of the therapeutic process. If the therapist were to view you as a friend, however, he would lose objectivity and be unable to provide effective therapy.


Hellboy

I agree too.

Certainly the issue should be handled as delicately as possible but they must also decide when further discussion of a matter would be counterproductive or even detrimental to the client. Hence, a general reason for termination and a referral to other services, without some long, drawn out debate about continuing services - the point is moot.

Hellboy

Agreed. The description of what happen is just too vague to make conclusions of any kind or to go wild with speculations as to what the therapist was thinking and why she did what she did. The devil is always in the details and the details are not provided here.

It is lawful for therapists to terminate at any time if they believe they are not competent enough to continue working with the client. In fact, not only it is lawful but also ethical. It's considered unethical for a therapist to continue to work with someone if they feel they don't have enough skill to work with that person, and, no, therapists don't always know that from the start. The work could start well and then it may become challenging and the therapist may decide he or she is not up to the challenge. This can be painful for the client to deal with, but that's what the psychotherapy laws and ethics say, at least, here, in the US. But I see you are in Spain, and I don't know what kind of laws pertaining to psychotherapy Spain has.

I must say, however, that if the therapist decides to terminate the work with the client, he or she should give them referrals. They are required to do so both legally and ethically, but, again, this is how it works in the US. Have no idea what Spanish laws say about that.

By the way, you don't have to attend the termination session if you don't want to. It's totally up to you.

As far as the counter-transference or the intolerance to criticism is concerned, these are the factors that contribute into the therapist's inability to work with the client, and so are also valid reasons for terminating the work and referring the client to a more capable practitioner. To put it simply, if the therapist starts feeling aversion toward the client, they should refer the client out, because it's unethical to continue working with them with this kind of feelings toward them, because those feelings will obviously make the work impossible. And, yes, of course, in the ideal world, therapists are not supposed to take anything personally, but in the real world they are humans and have their human limitations. This simple fact is well considered in psychotherapy laws and ethics. Professionalism in psychotherapy is not when a therapist is devoid of all human shortcomings and vulnerabilities, but when he or she is aware of his/her limitations and works within them.

High expectations of therapists often lead to clients' being traumatized. Unfortunately, therapists contribute in creating those high expectations by presenting themselves as all-knowing experts on the human soul, who are perfectly enlightened and void of human passions...but that's an entirely different topic for discussion.

Very nicely put.

Hellboy

I still see this as a miscommunication. Paula, you wrote to your T you didn't think it was working, she perhaps agreed but still offered a session to come in and talk about things in general, which you declined. That may have been intended as a session to further discuss your situation and not a termination session. Since you declined that opportunity to discuss things with her in person, there isn't much else to do. She's not going to pursue you because you already declined. Ts should offer termination a session but since you declined her request to discuss further the situation, the final decision was yours. She doesn't have to offer anything after that. T won't pursue you if you cancel sessions, turn down an offer or just never return. Even if you're struggling inside a T will take your word for it if you tell them therapy isn't working.

This seems to me to say that if there is ever a rupture, the therapy relationship is beyond repair. Current research as well as individual stories from many people on these forums actually suggest otherwise.

Nicely put. And I believe many Ts are of the opinion that it is also perfectly allowable for the client to yell at the T, and that yelling doesn't have to mean a rupture, or that the client is wrong.

I agree with what you wrote,a nd would add that Ts can have counter-transference which can interfere with objectivity. I'm not clear how this relates to the T knowing when the C should terminate and making that decision.

I too think you should make that termination session. I would want to know why? Our t's ask us to be honest & authentic, so I feel that it needs to work both ways. If your t thinks that another type of therapy would be a better fit, then your t needs to discuss this with you so you can understand. Don't allow your t to get off the hook that lightly!!! You deserve better. XXX

I think this is absolutely true. When I was seeing my T on a regular basis she'd check in with me periodically, asking if I think the therapy is working, if I'd like to change anything, and so on. Telling a T therapy isn't working is not a reason for termination and they usually are (or should be) open to discussion on how to change things.

I think it's very important to schedule a session so you have peace of mind or at least clarification. Are you unable to get a hold of her/ her office by phone (I'm sorry if I missed something your already said this)? Has she outright said that you cannot have another session or has she just not responded to your emails?

Interesting aspects you give here.

I think it´s most likely that there are similar rules and practices in my country concerning the therapists responsibility to end therapy if it doesn´t seem to help the client. I don´t know if a referral has to be an actual person? In my case I just got information about that I would benefit from psychoanalysis instead but I don´t know where to turn. I asked for a referral to a namegiven person but she didn´t have any.

The thinh mentioned about the therapists aversion towards clients made me understand that this aspect actually exists. I thought that "usual" complaints or criticism should be a thing that every therapist can handle but obviously it isn´t. I just wish I´d met a therapist that shared the idea that comflicts is something that could be used in therapy, not being seen as a reason for termination.

As you say, the therapist him-/herself often seems to try very hard to create trust, as my T did, showing me compassion and caring from the beginning. Then it all just ended and I now stand alone with noone to turn to, I now mean another proffessional.

When my T finally offered this session she´d already told me that she was more or less certain that we couldn´t continue. As I felt misunderstood and as I felt there was no room for criticism I also felt my trust in her more or less vanished.

I had of course taken this session if she had shown a more open and understanding attitude towards me reacting the way I did. As I told my T I wanted to find a solution but she made her decision anyway I just thought it would feel strange meeting her again.

I think this unfortunately is out of the question, to try to get in contact with her again. We talked to each other on the phone and she briefly told me that she wasn´t the right therapist for me and that I should try psychoanalysis instead. But several actions along the road didn´t feel ok and I still don´t get why she didn´t ask me right away to come into her office and discuss things. She showed resistance and irritation and that made me not wanting to see her again.

I think I´ll have to deal with the fact that I only briefly knows what went wrong. Perhaps, if I find another therapist, I could ask her to ask my former T about my records and through that perhaps find out more. But at the moment I just feel left out and I don´t know whom to turn to.