Ghosting on Freud - client - therapist breakup

https://www.theguardian.com/lifeands...onship-breakup

An interesting article which may provide or provoke an interesting discussion or argument ( ! ) The comments section I feel represents our discussions here , but reading it has helped me through some processing when I considered " Ghost terminating " my T.

Thanks for the article! Very interesting. The therapists commenting on the article are just... wow. Do they even realize how they sound?
Because they all sound like they have a huge ego and can't tolerate the slightest critcism about therapy. It's very telling. This idea that "patients" (notice they use the word "patient" and not "client") HAVE to come for at least X sessions before terminating is ridiculous. It's all about the therapist's feelings, not about the client's best interests.

What's wrong with using the word "patient" instead of "client"? I personally probably wouldn't want to see a T who would consider me to be her client and her offering me a service. To me it would be an indication that this T works on an unhelpful superficial level only.

Using the term "patient" is a huge redflag to me. They're not doctors (not talking about psychiatrists) and I'm not ill. "Patient" is patronizing imo. "Client" means that I'm hiring them and I get to fire them whenever I want. It's empowering. They are offering a service and I'm paying for that service. Therefore I'm a client.

As you can see, you can't assume that everyone sees those things the same way. For me, being a "client" and a T "offering service" are red flags. I'm dealing with very difficult stuff in therapy, which are in some sense a matter of life and death. Those things can't be approached to my mind with the attitude of "providing a service to a client".

I told Madame T what she was doing wrong until I was blue in the face. Dumping her without a word might have been better.

(It would certainly have been cheaper. Why should we pay to tell them they are not worth paying for?)

I didn't assume anything. I said "to me". If you don't mind the word "patient" then great. Also if a therapist is not providing a service to a client, what are they doing then? Are you not paying your therapist? Isn't your therapist offering a service the same way a dentist or a plumber would? Aren't you free to stop therapy the same way you would with any service that you're no longer happy with? To me that indicates that therapy is a service and that clients are customers. You are free to disagree.

And I do disagree. To me the T is not offering a service the same way a dentist or a plumber would. The fact that I pay for his time, doesn't render what he does "a service".

I was just raising the issue because you wrote: This idea that "patients" (notice they use the word "patient" and not "client") ..., which sort of indicated that calling a patient "a patient" is somehow really bad objectively. This sentence did not contain any reference "to you".

I prefer client because I feel like it minimizes the implied power differential. My former T said she was an expert in psychology and I was the expert in my own life/experiences and we were working together to help me feel better. I really like that characterization, and it feels more like a "client" role than a "patient" role.

I don't think about it in terms of paying for a service necessarily, since I pay my doctors and my dentist for the services they provide to me as a patient, and I feel empowered to go elsewhere if I am dissatisfied, just like I would if I were dissatisfied with my T.

I do wish that article had gone a bit more into why one might want to do termination session(s). Processing the work we had together and saying goodbye was one of the most helpful things I did with my former T. Although admittedly, I was leaving because of life circumstances, not because I was dissatisfied. I did go through a period of time when I came close to terminating abruptly with my current T, though, and I'm glad I told her why I felt I had to leave because it turned out to be a solvable problem. I gained a lot of insight on the way to fixing what happened with her, and in hindsight I can see that I would have needlessly injured myself emotionally if I had just walked away.

They are condescending arrogant overly sensitive ****s who greatly over-estimate their own value in my opinion. And I have always believed it is about their ego and bottom line rather than anything about a client (I despise the word patient and would never hire one who used that condescending term). I don't so much think of it as a service because I don't think those people really do anything besides sit there. I think of it like paying rent.
I have seen (for more than the initial interview of them) 3 of those people over the years and never bothered with them at all when I left - I just left and have not regretted it one bit. The 4th that I still hire will more than likely tell me she is retiring soon, I will say fine and that will be that. I will leave and that will be the end of it.

I think if they want feedback, they could offer a free session to clients who wish to leave. Unless driven by fear or to protect oneself or other reason, I personally think ghosting someone is a ****** thing to do as its devaluing someone as a person.

Therapists really shouldn't call their clients patients because having patients denotes having some responsibility for continuity of care. Therapists generally aren't responsible for care except for the hour you are in their office. More and more don't take insurance these days and don't want low income clients. There's a link to an article about therapist discriminating against lower income clients as well as articles in the New Yorker, the New York Times and others.

For many-as soon as you don't have money, you are cut off from services. That's a business relationship and thus you are a client.

I don't see how one is more empowering over the other. When you have money and are healthy there seems to be more choices, but get a medical condition where you depend on the decisions of others--literally because your decisions as a patient have little or no weight if you are even given the chance to communicate them--and see how empowered you are. You can't order your own lab tests or imaging in most states, and you have to fight with the lab to see the results because they go to the doctor. It doesn't matter what you need-it only matters what the doctor thinks you need. Any doctor can make any decision they want, and there is little you can do. To get a second opinion, you have to wait 3 more months to see another, who may diagnose you during their 5 minute assessment and you can be dead in the meantime. Information is hidden from the patient and they create intentional barriers to simply get your records. When you are sick or poor, there's nothing empowering about healthcare whether you are called a patient or client.

I am always so intrigued by the client vs patient debate. I would never tolerate a therapist calling me his patient. In my childhood I found the medical industry to be extremely abusive - Pediatric medicine didn't have much understanding of the effects of physical and emotional pain on children in the 70s and 80s. I suffered intensely at the hands of people who called me their patient, and it's not the kind of relationship I am keen to replicate. To me it denotes an attitude in which the doctor/therapist feels free to inflict potentially damaging treatments on people, with little regard for ill effects, under the guise of "doing it for your own good". No thank you.

Luckily I have found a therapist who gets this, and is non-hierarchical and anti-authoritarian. I noted before we even began working together that he calls the people he works with clients in his books and articles.

I find this article kind of sad. Such as this quote:
"The whole point of having a therapist is not being emotionally invested in them, [and] they aren’t emotionally invested in you if they’re doing their job right”

This is so far removed from my experience of what therapy is. In my experience, both the therapist and the client become emotionally entangled, and their working through these entanglements results in growth for both.

No doubt there are some incompetent therapists out there that deserve to get dropped. But if people bring the same issues to the therapy relationship that they bring to their outside relationships, and then they just "ghost" a therapist without warning at the first sign of a rupture, I don't see how they can have any hope of learning to improve their relationship skills.

The thing that seems sad to you is the the thing that makes therapy even the slightest bit tolerable to me. If I thought the one I hired had any emotional investment in me - I would leave immediately. I pay them to stay back.

And not everyone goes for relationship skills. I don't.

Ts seem to mostly say that a client should get closure by have some sort of termination plan. But I have never seen any kind of study that shows that clients are more satisfied in the long term if they have those termination sessions.

I also find it offensive for a t to say "we need to do termination sessions" when I am footing the bill. I think they should offer them pro bono if they are really that important to the mental well being of clients and ts.

There are therapists with whom I wanted termination sessions, mostly No. 3 (who also didn't charge for them).

There are also therapists I never wanted to see again once I decided to leave, to wit DBC and now CW.

It probably depends on the relationship. And therapists probably overvalue the quality of the relationship, because that's one measure of whether they are any good at their job or not.

And the money doesn't hurt either.

Me too. It's not necessary or desirable for everyone, but I could never do the trauma therapy I'm doing without some level of reciprocal emotional investment between T and myself.

I wouldn't ghost current T because she's good at her job, genuinely open to feedback, and I care about her. I wouldn't bother having a termination session with a T who didn't meet these criteria, however.

Thanks everyone for insights and feedback on this. I would welcome any thoughts on terminating a T being traumatic in itself ?

Thanks Out there for an interesting read. I personally think therapists who insist on spending 3 sessions to terminate are really disempowering clients and disrespecting their decisions. It's always a clients decision to stay or go and however they decide to do that, to ghost or not to ghost, that is their choice. Yes, as a therapist, it can be hurtful and you wonder why and wish they could have finished properly but they didn't and they did what was right for them and they did the best they could at that time. I also think it's arrogant and pompous of these ts who presume to be able to give the client a proper ending. That's horse ****, all ts have their own issues and contaminate the process, some unknowingly and others consciously. I have abandonment issues so I know it will be harder for me to tolerate ghosting because I will blame myself for not doing a good job.

Terminating my last t WHT and the previous one was very traumatic. I felt conflicted and alone because usually I would talk to them about things like that but I was dumping them. It's was very confusing and heartbreaking because both were really upset. I felt like they both took it personally and so I blamed myself for hurting them. I remember my second t cried her eyes out when we had our last session, it was very difficult for me because I struggle with endings, separation and attachment issues.
I think that ts can either cause a termination to be traumatic or be the cause of the trauma. My ex t was retraumatising me for a very long time before we terminated but seeing her vulnerability and her hurt really struck a cord with me and I punished myself for a long time afterwards.
The more they fight it the harder it is for the client.

Thanks Mona - I suspect my own issues contribute to me considering ghosting a T - but I can work on that.

As far as the client vs. patient semantics goes, I honestly don't give a flip either way. I've never had a therapist refer to me as either; they called me by my name. Seems like that's what I prefer.

I've never had a therapist insist on even one "termination" session (never had one call it such a thing) much less multiple ones. If I chose to stop seeing a therapist, I simply stopped seeing them. To my knowledge, they weren't bothered by that if I hadn't seen them very long. The ones I had seen for a length of time completely respected my wishes, let me know they were available if I chose to come back, and we parted on good terms.

Do you think it's because you'll be compelled to stick around if you decide to talk about it before quitting?

For what it's worth, in my experience, termination hasn't been traumatic.

With former T, I made the decision to quit only after I'd tried really hard (as she also acknowledged) to stick it out. Once, I made the decision, I spent exactly one session (the last one) telling her that and then left.

It sucked in terms of my feeling a sense of loss and for a long time, I'd keep comparing her to current T but that wasn't really unbearable or anything.

With current T, I'd found another sort of viable T but I was genuinely unsure of whether to leave or stick it out or see both of them for a while or take a break from one and see the other etc. I'd discussed it with the new T and came to the conclusion that I should just talk about it all with current T and see how it goes.

So, I talked to current T and told her pretty much my whole dilemma and all my options and somehow in that session, she "came through" strongly enough for me to feel like it was worth it to stick it out with her rather than switch (at that point anyhow) to the new T. I did though like having the option of potentially being able to see the new T if things got bad with her again -- new T had said I could come back any time.

The ruptures with current T (leading to me seeking a new T) were gawdawfully painful but not the actual session / talking about it etc. I'm fairly certain that even if I'd decided at that point to leave her, I would've done so with a sense of okay-ness / peace because it would've been from a sense of not being seen / heard by her. So, either way, I would've felt like I'd done the best I could and that'd be that.

It was very traumatic for me, but i had no choice, no alternatives. I wasn't ready to leave theray with him. It felt traumatic for a few reasons, one was it felt like when i had to legally emancipate from my parents when i was in a crisis as a teen, the second was feeling worthless because he had no concern unless i had something to offer (money), third feeling ostracized, also the fact i am struggling with medical problems and the ptsd that goes with medical treatments, and needing him more than ever. Then the way he handled it. There are other things mixed in it all.

Not sure how or when i will recover. Im devastated over this.