Why do clients cancel their sessions?

What does it mean when a client cancels a therapy session? Has anyone here ever canceled a session (for reasons besides illness, an unavoidable schedule conflict, etc.), and if so, why?

My next scheduled session is in two days, and I'm thinking of canceling. I'm trying to understand why I want to do that. This session will be the second couples session for me and my husband. I won't have seen T in an individual session for 2 weeks. Why am I getting cold feet? I have never canceled a session with this T before, but rather have looked forward intensely to each of my individual sessions, even if we were doing difficult work. I'm just having this overwhelming urge to cancel. I hate being so clueless about my motivations.

I do feel overwhelmed with couples issues, based on what happened in our first couples session last week. I just feel really unstable and emotional right now and like it would be hard to go to therapy like that, especially in the triad context. Is that a good reason to cancel therapy, because you are feeling too unstable and fragile? I feel like so much is happening and my ability to process everything is hopelessly behind. I'm on overload and going to therapy seems like it will only add more to process. Maybe if I have an additional week before therapy, I can get things under control better. But maybe that would be counter to progress? Is it good/helpful/productive to be so unstable and out of control?

I'm also feeling somewhat abandoned by my T since I called him midweek last week to ask for an individual session and he never returned my call. It might be uncomfortable to go to couples therapy with that ignored call between us, and I would feel unable to discuss this "between T and me" issue with my husband present.

So maybe it's a mix of these two reasons. I don't know. I'm just feeling up in the air about this, and ready to pick up the phone tomorrow and call to cancel. Or maybe I could just go to the session and be more of a bystander and let T and my husband carry the weight of the session. I could just distance myself and try to hold it together. Or would it be better to cancel?

can you try again to contact your therapist? if you could sort out his never returning your call then maybe that would help things a little. i guess under the circumstances i'd be tempted to cancel too. sometimes when i'm in that position i try and think 'what would the healthiest way of dealing with that be?' can be a hard question. i don't know. i guess it just seems to me that if you do go to the group session with his not calling you back as the elephant in the room then yeah, it would be hard to talk. i know i'd feel kind of shut down from everything.

it is hard to go when we are feeling fragile. would you be able to say that you are feeling fragile in the session though? maybe your husband is feeling fragile too. sometimes one feels fragile because one is kind of on the edge of very real gains. could you try phoning tomorrow not to cancel, but to briefly talk to him?

I think the dynamics between a T and couples is tough. If the T is seeing you and your husband in personal sessions I wonder how she/he manages to keep every bodies stuff personal. And then there is the dynamics you mentioned about the T seeing one but not the other… I would be a little upset if my T never called back—that has never happened to me. Couple therapy is tough. If you feel overwhelmed, then tell the T…pushing yourself beyond your limits is not going to help you or your husband. Have you mentioned this to your husband?

The only times I have cancelled a session…well, one time I had a really bad T and it took awhile for me to get up enough guts to fire her. So, a few times, I just canceled our sessions. That was kinda sad, when I told her I wanted to terminate therapy she got upset and talked me into coming back a few times. Finally I had to be a little assertive and tell her it was really over—she kept asking why, so I told her the truth—that she was a bad therapist. She cried. I felt bad about making her cry, but she kept pushing me for reasons and I could not bring myself to out and out lie. She was a little weird.

Sorry, I got a little off topic. Really, follow your heart and do what is best for you. The only way for your relationship with your husband to get better is if you both take care of yourself first…and then work on the relationship.

Sunrise - Your post was really interesting to me because I had similar feelings just a couple weeks ago. I also intensely look forward to each session and never thought about canceling. We also have the couples thing in common. I don't know if you remember me, but I see my T individually and also for couples.

In my last couples my T said something that kind of upset me. I was going to bring in up in my individual session but we got going on another topic and I never got around to it. Then I felt like we'd gotten to the point were we had talked about all the 'easy' stuff and it was going to get more intense. I hate the idea of crying in front of anyone and it just seemed like some of my numbness was gone and that was what was going to happen. Also, I was feeling some pressure on the marriage front.

Anyway, all of a sudden I got the idea that I was going to call and cancel my session. I had a lot of frustration built up and I had this bad idea that I was just going to quit therapy and move on. By the time my next session came around I had cooled down a bit and even though I was anxious I did go to my session.

It turned out I was really glad I went. I told her what happened. We talked about it with the promise to talk about it again this week. She even scheduled me to come in after one week instead of two. It turned out to be a really positive experience.

I just share this to give you encouragement to continue on. The couples and individual thing can seem really confusing and difficult, but if you have a good T (and sounds like you do) they are trained to handle this stuff. Good luck and I really hope you either call your T or bring up your concerns in your session. Remember just because it is a couples therapy session doesn't mean you can't bring up individual concerns as well.

I think you have already answered the why : between the phone call not returned, and having session with your husband, it would be totally normal for you to feel fragile and emotional.

Do you feel as though something has been taken away from you because of these factors?

I am not sure, but you seem like someone who likes to keep her emotions in check-- and it sounds as if this week, it might be a little harder than normal to do that-- so perhaps you would rather avoid the trigger than have to deal with the intensity of emotion. I don't blame you for feeling this way!

I really encourage you to attend the session. However, you need to get that T of yours to make room for an individual one, also! There is a lot of stuff going on for you now that you need to take care of between you and him. Time for you.

I agree with calling to talk first...before cancelling.

Is your fragility regarding your relationship with your T (for not calling back) or with your husband or with the work you are doing there?

If it has to do with the work you are doing there then it may be beneficial to show it there... well I do that in individual. How would you feel about showing that in front of your husband?

It is difficult for your T perhaps to shift roles as he wishes to support you but now he is doing work with both of you. My thought but I do not know.

Might you even talk to him before the three of you sit down in the room.... like without hubby in the room? Could that assist at all or would that be too much at one time?

Good luck

Sunrise,

I thnk you really need to resolve the issue of your individual sessions. This is clearly bothering you as it would me. I also have had very mixed feelings about couples work and we (me and T) kind of put that discussion on hold without stating it.

In the for what it's worth category, I have been told by a trusted friend who is a T, that couples work is harder than individual. I think it's because it's another identity to work on and just as painful to look at the warts as it is when we look in the mirror. When it frays as the edges or unravels it is a part of ourselves that feels so fragile, just as it is in individual T. It's so confusing when we find ourselves in another person, but are fighting to pull ourselves out of that identity. Does that make any sense?

So your reaction is probably appropriate. I don't think you should cancel but if T doesn't call you back use the time you see him to ask for an individual appointment.

Good luck. It sounds like your are working really hard.

Peace.

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It's so confusing when we find ourselves in another person, but are fighting to pull ourselves out of that identity. Does that make any sense?

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That is interesting. Is this a matter of being one person alone (or in therapy) and another with spouse? I could see this and it would be also be interesting for the therapist to meld the two when working with you.

I too think you are working hard... and going would be an important thing.

Thanks alexandra_k, DepressMe, Lemon, SecretGarden, sister, and pinksoil for your comments. ((((hugs))))

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can you try again to contact your therapist?

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That is so sensible, alex_k, but no, I can't. It took a lot for me even to call him the first time, really putting myself out there, and I got rejected. Can't do that again. Plus (rationalization coming), he has told me once that he doesn't always check his phone messages every day, so if he doesn't return a call right away, that's why. So if I call today, he might not even get my message before our couples session tomorrow. So why bother?

Still haven't decided if I should cancel or not. I have to remember that my husband is part of this too and would have to be involved in a cancelation decision. It would not be fair to him to cancel unilaterally. Alternatively, I could just not go and my husband could go solo, which I totally would hate!

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Is your fragility regarding your relationship with your T (for not calling back) or with your husband or with the work you are doing there?

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SecretGarden, my fragility is about the relationship with my husband. But the T thing isn't helping any. That's part of the issue--now is not the time for me to have issues with my T! I need all my resources to deal with the marriage. I need T to be really dependable and rock solid for me and not add to my load of turmoil by ignoring my phone call.

DepressMe, that must have been hard to split up with your former T, and make her cry, even though she was not a good T.

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The only way for your relationship with your husband to get better

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We decided at our first couples session last week to get divorced, so our marriage is not going to get any better. But I am hoping our relationship can improve so that our divorce will be a good one. It's a tough time right now for both of us. Even if you want to get divorced, after 20 years together, it's heartbreaking. My T is a family therapist and divorce expert. He handled our first session really well--he did a great thing for us and I am so grateful.

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some of my numbness was gone and that was what was going to happen. Also, I was feeling some pressure on the marriage front. Anyway, all of a sudden I got the idea that I was going to call and cancel my session.

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Lemon (yes I remember you!), I think that is part of what is happening with me. I am just so hurt and fragile but angry and elated too, all in a mix, bam bam bam these feelings rapidly one after the other all day long. Numbness is gone. I feel I can't contain if I go to therapy. I am certainly not containing outside of therapy. We are supposed to talk about nuts and bolts stuff at our session. I just don't know if I can. And it would be horrible to just sit there in a corner and cry while T and my husband discuss the nuts and bolts.

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Remember just because it is a couples therapy session doesn't mean you can't bring up individual concerns as well.

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Lemon, I didn't know that was permitted. That's good to hear. I would hate to ask T in our couples session if I could have an individual session too and have him say no in front of my husband. Rejection is bad enough, but in the triad setting, I would be devastated. Thanks so much for your encouragement. Maybe I will try what SecretGarden suggested and try to get a few minutes alone with T at the beginning of our session.

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It's so confusing when we find ourselves in another person, but are fighting to pull ourselves out of that identity. Does that make any sense?

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Yes, I understand completely, sister. It's very frightening.

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Remember just because it is a couples therapy session doesn't mean you can't bring up individual concerns as well.

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Lemon, I didn't know that was permitted. That's good to hear. I would hate to ask T in our couples session if I could have an individual session too and have him say no in front of my husband. Rejection is bad enough, but in the triad setting, I would be devastated. Thanks so much for your encouragement. Maybe I will try what SecretGarden suggested and try to get a few minutes alone with T at the beginning of our session.


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I supposed every T is different in how they handle the individuals in a couples session. Our pattern has been for my T to ask each of us how we are at the beginning of each couples session. Since the individual effects the marriage I think most T's know they can't ignore the individual. My T will steer us to couples issues and deal with my individual stuff in our private session, but she allows some time to understand where each of us are at emotionally and what has been going on in our lives.

I know that fear of rejection in front of your husband must be hard, but from what you've said about your T that doesn't seem likely. Good luck

Are you sure you aren't just angry with T?

I haven't cancelled with this T but I did with the last one after she cancelled on my for 3 weeks straight. It was anger, revenge for sure.

I have decided that when I feel the urge to cancel is when I really really need to make sure I go. Those are the times I might walk in and say I want points for just showing up. When I have made myself go, I am always glad I have.



ECHOES

P,S, I just got my Amazon order that includes "In Session", "The Gift of Therapy" (Yalom), "inside Therapy", (Rabinowitz), and "Between Therapist and Client" (Kahn) and I can't wait to get to them, especially "In Session". Thanks for recommending that one!

Reason I cancel: FEAR! I cancel with my internal med doc cuz I'm afraid I might cry. It seems I cry all the time now, but esp. with docs & therapists. Meds provider & internal med doc say I need marrital counseling--can't do it--too much fear--of being hurt, judged negatively, exposed for the weak, awful person I really am.--Suzy

It sounds like the divorce and couples therapy is VERY hard for you. I think it would be very hard for me too. I have not ever canceled but I am not even close to married to someone. I think that I would have a miserable time if I was divorcing someone.
I suspect that your T would say "yes" and try to schedule an individual session if you requested one. He might even bring up your phone message in your couples session and schedule one for you. I doubt that your T is saying "no" or rejecting you. He probably just didn't get the message and will probably bring it up during the couples session. When is your next individual session with T? I hope you can get the guts to go to the session and tell T how you are feeling. He might need to slow down on some of the work that you are doing in couples therapy. Sometimes, our anxiety is a sign that our Ts are going to fast for us and need to slow down but Ts can't read our minds about this. So we need to let them know when they are running ahead of us.

Some years ago I was seeing a t for individual and then asked her for help with marital....I had two individual sessions each week, one on Monday and one on Thursday. And Wednesday we had marital sessions. I always needed to talk to her after a marital session. She was after all my therapist.
My t always returned calls. Same day or next, but never later.
I would call t again and leave a message saying I really need to talk to her before coming for another marital session. I'd mention that I'd left a message last week, asking for an individual session, and did she get my message? I'd say it's important for us to talk before having a marital session and could she give you some time over the phone or in person?

Dear, this is hard. I know. Take gentle care,

Thanks Suzy and ECHOES.

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Are you sure you aren't just angry with T?

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Maybe a little, ECHOES, but I don't think that is the main issue. I have such big stuff going on with the marriage that I just cannot handle it. I am crying a dozen times a day or more. Today I heard a trivial thing, totally unrelated to anything, and burst into tears. I just don't know how I can handle a session in the couples format tomorrow when I am like this, falling to pieces. I need an individual session. I would cry with T if we were alone, and I bet it would help. Plus, maybe he could help normalize my experience since he is the divorce expert. Alternatively, if I cancel tomorrow's couples session, I have another week before the next couples session to get it together so I can make it through the session when it finally happens. Maybe the extra time to process would help me. Things are just happening so fast. I want to slow it alllll downnnn.

I really don't know what will happen tomorrow and I'm dreading it.

At least if I go tomorrow, maybe I can work up courage to ask T in person for an individual session. I know I would never be able to call him for that reason again.

ECHOES, enjoy your reading. Sounds like a great book list. I am currently reading Love's Executioner by Yalom.

Suzy, have you considered marriage counseling with just you going? It's less threatening. Lots of individuals go for marriage counseling. You can work up to couples sessions if you need to.

Hey Sunrise,

I just had a crazy idea. Can you usurp the couples session somehow and turn it into an individual session. Can you just ask your husband if he would mind not going until next week together? Can you just let him know you have to prepare more or something?

Just a thought......Keeping you in my thoughts.

Be good to yourself. I agree, you need time to get yourself together.

Thanks Hopefull, withit, and sister.

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I suspect that your T would say "yes" and try to schedule an individual session if you requested one. He might even bring up your phone message in your couples session and schedule one for you. I doubt that your T is saying "no" or rejecting you. He probably just didn't get the message and will probably bring it up during the couples session.

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Hopefull, I now know why you chose your screen name because it sure fits you. Thanks for your hopeful comments. I hope T will bring this up tomorrow and schedule me. I so hope you are right. (((hugs)))

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When is your next individual session with T?

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I have no individual sessions at all scheduled with my T. That is why I called him, to try to schedule one. If I could see him individually, I would definitely tell him how I am feeling. I am wondering if he is willing to give "my family" only one session per week, and that's it. Either my husband and me together or just me, but not both of those combinations in one week. And that's why he didn't return my call. I got too greedy and wanted too many sessions for my family. I crossed a boundary. I sure wish he would just tell me this stuff if this is the case, instead of letting me stumble blindly into his "rules."

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I would call t again and leave a message saying I really need to talk to her before coming for another marital session. I'd say it's important for us to talk before having a marital session and could she give you some time over the phone or in person?

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withit, that's exactly what I said in my phone message last week and I got ignored. The thing is, my T has told me that he doesn't check phone messages every day (he has a voice mail, no secretary), and so if I left him a phone message tonight, there's a very good chance he wouldn't even get it before our couples session tomorrow. I had been counting on hearing from him today (hope springs eternal), but he didn't call.

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Can you usurp the couples session somehow and turn it into an individual session. Can you just ask your husband if he would mind not going until next week together?

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sister, that is an idea I've had but I don't think it is fair to my husband. In session tomorrow we have some important nuts and bolts stuff to go over with T to get this show (the divorce) on the road. I can't ask my husband to wait on this. And it is important for both of us, not just him. I don't think this is the answer, but thanks for the suggestion.

As an example of how I have not been able to process much since last session, I have not written in my journal in over a week, and I usually write all about my session to help process it. I've not been able to do anything.

Thanks so much everyone, for letting me go on and on about this. I'll let you know what happens tomorrow.....

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sunrise said:

I'm also feeling somewhat abandoned by my T since I called him midweek last week to ask for an individual session and he never returned my call. It might be uncomfortable to go to couples therapy with that ignored call between us, and I would feel unable to discuss this "between T and me" issue with my husband present.

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I'm sorry sunny. I never heard from my T's office either. He better have been on vacation or something...or else....

When I had couples counseling with my T, I also had that same week and individual session. Can he do this with you? Have you asked him for it? In couples counseling, the focus is on what is best for the couple not always the individual...

Just an idea. Would your insurance fight you w/2 sessions per week?

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When I had couples counseling with my T, I also had that same week and individual session. Can he do this with you?

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Well, he never called back when I asked for this, so maybe that is his way of saying "no." We already had tomorrow's couples session scheduled, but no individual. Previously, when I agreed to do couples with him, I asked him if I could still come to see him myself. He said yes, that I was not going to lose him, he would continue to be my therapist.

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Would your insurance fight you w/2 sessions per week?

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My insurance does not pay for any sessions with my T, couples or individual. This is not an issue.

Thanks for your thoughts, almedafan. Sorry to hear what happened with your job today.

sunny,

Could you ask for a few minutes alone with T and talk to him about all this before bringing in your husband?

((( sunny )))

i cancel all the time
i go in and out of T
like mnths with no contact

i cancel cos im scared what i will find out
ive already been diagnosed with some frightening things
and being told to take meds
when i dont want to really take them
being ill scares me and going to T makes that more real
i dont want there to be a problem
so ignoring mite help
maybe for two seconds..lol

im scared to relive what got me to this place
im embarressed about my past my fault or not it still happened to me and im ashamed of it

there are so many reasons
but one thing is for sure
the only way to get better in my case at least is to go to T
get it done
the longer i leave it the harder it gets

((sunny))

Hi sunny,

I hope the session went well for you.

I was thinking of your question and your situation yesterday and I wondered if "not wanting to go there' (the work, psychologically) was being translated into "not wantng to go there" (to the session, physically) and making you think of cancelling.

Anyway, I hope it went well and you get some one-on-one time with your T, too.

ECHOES

Thinking of you Sunrise. You are going through much and it is natural that it might be alot to take at one time and that you would like to slow down. I bet your T has heard that before. Hope that your session went? well and look forward to hearing how you are.

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ECHOES said:
P,S, I just got my Amazon order that includes "In Session", "The Gift of Therapy" (Yalom), "inside Therapy", (Rabinowitz), and "Between Therapist and Client" (Kahn) and I can't wait to get to them, especially "In Session". Thanks for recommending that one!

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I have them all too Echoes! I can barely put the books down when I get them. I just got Nancy McWilliams about personality and the clinical process. She is a fabulous writer...have fun