[chihirochild]

Due to my pdoc and t having unfortunate life circumstances resulting in an inability to provide consistent care (pdoc has a brain tumor and is getting chemo, t is out of the country caring for her sick mother), I'm transitioning my psych care to a different hospital system. I've been in limbo for the last several months but I finally met with my new therapist (who is fine, I guess) and he told me that I should plan to wrap up with my pdoc by the end of the month. (He also said I should plan to see currently-out-of-the-country t once or twice when she's back so that we can come to some sort of ending as well.)

I saw pdoc today and let him know about the end-of-the-month deadline. (He has been doing therapy with me every other week in addition to med management so this imminent stopping feels like an actual termination of therapy, not just a switching of prescribers.) We decided that after today I'll see him one more time and that will be it. I had hoped that he would, like, guide the process somehow but that isn't really what happened. When I asked how he usually manages terminations, he said that he doesn't do a lot of them--he's been at the same clinic for >10y and most of his patients have chronic severe mental illness so they need care forever; the only times he's had to terminate is when people move or some such thing. (I said, "so neither of us know what the f*** we're doing?" He didn't especially appreciate that.) He said that he wanted me to know that he has truly enjoyed working with me. He said that if I come out of the process feeling like the termination was because of external circumstances and not because I am "too much" for him, that will be a success.

That just feels like a pretty low bar to me--what about, like, looking back at the work we've done together? Things that went well and things that didn't? Or hopes for the future? I don't know exactly what I want, but what he outlined is not it.

Does anyone have any thoughts on how to orchestrate a graceful and meaningful termination even if your therapist is unable to do so?

[ruh roh]

Oh man, this is a tough one. On the one hand, it's a termination of your therapy with him, but it's not a termination of therapy. If it were the later, then a review of the kind you laid out would make sense, the result of a successful conclusion to your therapy.


Since it's more about having to leave him, could you both talk about a plan you might have going forward? Things to build on? Pitfalls to watch for?

I agree that just saying it's a success because you don't feel that he's rejecting you is pretty lame, but who knows how he's functioning with chemo brain. Maybe it's all he feels he can offer. In which case, asking more about a plan and strategies for your road ahead might be the way to go.


I would definitely let him know that his idea is like saying that feeling you have no control over the situation is better than feeling like it's your fault--where is the empowerment in that? I mean, I guess it's what therapists say about childhood abuse, but it doesn't seem to fit here at all.

[InnerPeace111]

An option is to plan and lead your own meaningful and graceful termination with the ideas you outlined in your post — your successes, setbacks, and hopes for the future. Guide him through the process instead of him guiding you. You might be pleasantly surprised at how well it goes.

[CantExplain]

Have you explained your agenda to him? I don't see why he shouldn't agree to it.

[luvyrself]

Originally Posted by chihirochild

Due to my pdoc and t having unfortunate life circumstances resulting in an inability to provide consistent care (pdoc has a brain tumor and is getting chemo, t is out of the country caring for her sick mother), I'm transitioning my psych care to a different hospital system. I've been in limbo for the last several months but I finally met with my new therapist (who is fine, I guess) and he told me that I should plan to wrap up with my pdoc by the end of the month. (He also said I should plan to see currently-out-of-the-country t once or twice when she's back so that we can come to some sort of ending as well.)

I saw pdoc today and let him know about the end-of-the-month deadline. (He has been doing therapy with me every other week in addition to med management so this imminent stopping feels like an actual termination of therapy, not just a switching of prescribers.) We decided that after today I'll see
him one more time and that will be it. I had hoped that he would, like, guide the process somehow but that isn't really what happened. When I asked how he usually manages terminations, he said that he doesn't do a lot of them--he's been at the same clinic for >10y and most of his patients have chronic severe mental illness so they need care forever; the only times he's had to terminate is
when people move or some such thing. (I said, "so neither of us know what the f*** we're doing?" He didn't especially appreciate that.) He said that he wanted me to know that he has truly enjoyed working with me. He said that if I come out of the process feeling like the termination was because of external circumstances and not because I am "too much" for him, that will be a success.

That just feels like a pretty low bar to me--what about, like, looking back at the
work we've done together? Things that went well and things that didn't? Or hopes for the future? I don't know exactly what I want, but what he outlined is not it.

Does anyone have any thoughts on how to orchestrate a graceful and meaningful termination even if your therapist is unable to do so?

—-I would concentrate first on getting their referral to new people. Then type up your psych history, a timeline to show cause and effect, meds u can’t take, etc so that it will not take so long to get up to speed w yr new staff. Be firm about getting a debriefing and goal setting from the docs that r leaving. I’m going to have to monitor myself about this because I just started a new pdoc and have been very lazy lately about making a prioritized list of topics when I see my professionals. Hugs!

[Anne2.0]

Originally Posted by CantExplain

Have you explained your agenda to him? I don't see why he shouldn't agree to it.

I quite agree. I wouldn't interpret his statements as he "doesn't know how" but that he is unsure how to be helpful to you, because like everything else in therapy, it's individual. It seems to me that telling other people they don't know what they are doing is likely to push someone away or decrease their motivation to assist you, or other sabotage an ending that is right for you.

I think if you let him know what you'd like from him or sketch out an outline of what termination would look like for you, you'll move things along.