Skipping sessions

I’m wondering how your T’s handle skipping therapy sessions. I like my T very much, but I’ve had a huge push-pull relationship for 2 years where I pretty much always struggle with coming. I like him and part of me very much likes coming, but part of me feels like I shouldn’t, so it’s a struggle. I’ve quit via email several times, then unquit . I’ve canceled sessions via email multiple times and I usually uncancel. My T says therapy is about choice and it’s my choice to come or not. Last week, I no-showed. It was totally premeditated. I just wanted to see how it felt, and honestly, it was strangely empowering. I saw him this past week and we talked about it and it was good. Then the next morning, I was scheduled to see him again (usually see him twice/week) and as soon as my alarm went off, I just stalled and couldn’t get out of bed. I was tired, and also came up with all sorts of reasons why going would be difficult for me. I eventually sent him a cancellation email about 45 minutes before my early morning appointment which was his first appointment of the day. To my surprise, he responded to my email which he rarely does. He said he didn’t get my email until after the session had started and he was surprised I canceled. He also said he thought it would have been better if I had shown up and talked about why it was hard for me to come that day. I feel sort of strangely affected by his emai response, in part because he does not typically respond. Mostly, I know he’ll be fine with it and it’s my choice whether I go or not, but I’ve also had moments of panic where I fear he’ll say he’s fed up with me. I also had a dream where I tried to talk to him about it but couldn’t because there wasn’t enough air in the room and I was suffocating. I realize this is probably unconscious stuff but it feels real and scary when I’m having those thoughts.

Of note, the couple of times I’ve skipped I’ve paid for my appointments, so I wasn’t completely standing him up. I’m just wondering how other T’s handle the whole skipping thing.

It sounds like your therapist is basically okay with it and you do pay even if you don't show.

Mine would have called me on it though, paying or not. I never cancelled unless it was just unavoidable, but my husband had a habit of forgetting when his appointments were. He truly was forgetting them; his memory is truly awful. But our therapist expected consistency from us as he was also consistent. He was finally able to open up a permanent spot for my husband's appointments which helped immensely. So basically, he would have talked about it as a problem to be figured out and helped us come up with a solution.

I have skipped sessions couple of times. My T was ok with that. He waited for me to raise the topic next time. I assume that if I hadn't mentioned it at all then he would have found a way to address it at some suitable moment though.

To be precise, I've skipped sessions two times, which were two days in a row and I was actually out of town but I preferred not to tell him. On the third day I could not resist anymore and called to ask what he was thinking about me not showing up as I had never missed a session before.

On another time I was travelling and I did not tell him again. Then I called him again but just about 5 minutes late, so he would have had the chance to start wondering what's going on with me (because normally I'm never late).

The money part is similarly a non-issue - my T has no cancellation policy what so ever and so I will pay for all my sessions anyway, whether I show up or not.

It seems to me that your T's reaction is very normal. For some reason you need to do it and then later you can talk about it.

I never just skipped - I always made sure to cancel because I was not going to pay the woman if I was not there. I would cancel at least once or twice a month or just take month long breaks a few times a year. The woman never said a word about it. Which is best - I would not have responded well to pressure of any sort. I wanted to make sure she would stay back.

I have the same spots at the same time every week, so it’s not a matter of forgetting. Last week I chose to skip on purpose without canceling. I’m not sure why, but it felt liberating. In real life I wouldn’t do that, but in therapy I thought it would be ok, and it was. This week I hadn’t planned on skipping and I ended up feeling disruptive to me for some reason.

Yes, last week I wanted to skip on purpose without notifying him, and I liked the idea of him sitting there wondering where I was because I’m usually quite considerate and responsible and this felt different. I wanted him to email inquiring about where I was, so that I could ignore his email., but he never did. Then this week I canceled at the last minute without planning to. He did email this time and I felt very disrupted by his noticing and sending an email. It felt completely different than the previous week when I skipped in a premeditated sort of way. This week I felt guilty and worried about the status of our relationship even though logically I know that it’s probably fine.

My T and I had a miscommunication and I thought my appointment was at 2pm but it was my usual 1pm... T started calling and texting at 1:10 extremely concerned. I have never been late for an appointment (I am always 10+ min early) and never no showed. So... it would be very upsetting for my T as he would be very worried about me. I am not sure how he would handle it the next session... although he might call me and cancel the next session unless I made some contact to confirm I was going to come.

I have never just no showed. T and I had a couple of appointments early on that I had in my head were scheduled for a later time. She called me ver concerned because I was never late, no showed or even can elledge for that matter. I think I cancelled twice due to illness in 10 years.

As I think of my struggle with canceling or skipping, I have to at least commend my T for being incredibly consistent. He’s never missed or been late or even been sick in two years. Maybe I just want to see what it feels like to be the unreliable one for a change. To be a flake, and have someone still be there for you. It’s a little unnerving.

Or is it a test? To see if he cares?

I have only been late to one session with L and it's because I fell out of bed and hit my head that morning and I had to take time to make sure I was okay. The only times I've had to cancel is when I had surgery or dental procedures.

For me, my time with my Ts are short, precious, and valuable. I don't like wasting my time or theirs. I would be too afraid to test them anyways. One time too many and they might leave. (Though if they're honest with me, they wouldn't.) I also can't afford to miss sessions.

Now I have "threatened" to no show. That is usually testing. T is great about it. She knows how much she means to me, so when I say that I might not show up, her response is "See you next session"...lol. L takes it a little more seriously. She tells me to come in, talk about it, everything will be alright. She's very reassuring and encouraging.

When I first met my T he went over his policies. No shows? With no valid reason I would still be responsible to pay for session. If I were to start to cancel ? we would find out why and if I’m just not interested in actually helping myself in Therapy he would cut me loose.

So now 8 + years later I have never just been a no show. Over my 8 years with my T I have been sick twice and had to cancel day of appt and once because my Husband was in the hospital.

I can’t say I’ve ever struggled with going to a session really , yeah some times I’ve literally forced myself to drag myself in while in a nasty depression... but I always feel better afterwards even if it’s just a tiny speck.

He has only needed to cancel our sessions a hand full of times over the years.

Mutual respect really

I have skipped a couple.
I know I have to pay regardless and I'm fine with that commitment.
I've skipped for different reasons.
T handles is well.
Either says, she thinks it works be better for me to come in and two and it or has says she's there if I change my mind.

I've never no-showed and I pay for cancelled sessions. Last week I just didn't want to be bothered and cancelled several days in advance. I knew, aside from just feeling exhausted, why I was cancelling and had no intention of talking about it. But of course we did. And I wish we hadn't. I'm not happy with myself that I allowed that discussion to happen .

I very rarely cancel a session. Even when I was horribly unwell I used to drag myself to see T1. The need was so strong that I just had to get there. I did cancel one with Ts when I had flu but as I didn't pay her anyway it wasn't an issue. I think T3 had a policy about cancellations on the day but I never cancelled. I haven't with T4 but I strongly suspect she would just suggest rearranging rather than charging me. I see an alternative practictioner and because she knows me we will always re-arrange a day rather than ask me to pay for the missed session.

I've never no-showed either, never even considered it. I canceled therapy sessions last minute several times, mostly when I was in a relapse with my drinking and preferred to either drink or was too sick with a hangover to go. With first T, his policy was a 24-hour notice to avoid payment and I always paid him without even a word when I gave a shorter notice. With second T, I only canceled once the night before the morning session and I was ready to pay, but he did not want me to pay and offered a session later in the week, which I took.

I never thought about skipping a session due to having ambivalent feelings about therapy or the therapist; when the negative got too much, I just stopped going altogether or took a long break (months). I do think taking breaks can be good especially if someone does feels overly hooked/preoccupied and does not like it. I had a period of similar kind of ambivalence to OPs pattern and I found it so unpleasant, I did not want to tolerate it hoping it would lead to something good. I imagine it can be quite unpredictable whether skipping when overwhelmed will make one feel better and more grounded, or perhaps still going to session would be a better remedy.

As for how it affects the therapist - I would not care about that one as long as I make my payment when we had that kind of arrangement. What I would care much more about is appearing chaotic and unable to stick to a plan, I would rather feel bad about my behavior than whatever the T might think about it. In part, because I have quite low tolerance to that sort of behavior from others as well when it becomes clear it's a pattern for them and not due to occasional unforeseen events and emergencies. A T must be prepared to tolerate and address these kinds of patterns though on an emotional level, it's not the same as acting randomly with coworkers, for example. Still, I understand that the urges and acts make you conflicted because I am sure it would be the same for me.

I have considered cancelling several times because I just wasn't in a good space. I have always contacted them to tell them I was thinking of cancelling. Both have been wonderful and replied that they understood and if I really wanted to cancel they understood or I could still meet them and we could explore what was going on or at least have a light session. I have always gone.

The 2 times I actually cancelled, once I was vommitting and the other I had been in the ER the day before with a UTI that they thought was septic. I was so sick I was in bed for a week unable to stay awake and eat.

I never felt bad about cancelling and I doubt the woman cared, but even if she had - that was not my problem. I gave her enough notice to find another sap if she wanted to fill the space.

I think I was spoilt in this regard.

I did no show without giving him notification once and he never used to charge me for missed sessions. For me anyway he always felt more softer the next session back.

I was a bit nutty with Christmas and birthday gifts and did give him a £30 gift card once which would have been less than the price of a cancelled session.

I cancelled my T appointment for tomorrow. I had another commitment come up and I could have still made it to T but it would have been close. I just evaluated how I was feeling, I was still outside of the 24 hour mark, she hasn't been terribly helpful of late, so I cancelled. I've never no showed though.

Hmmm, maybe. Or maybe I just want to affect him. There aren’t really many ways to do that in this relationship.

Do you think skipping sessions like that affects him much? I would think that going there and very directly telling him what bothers you might affect him much more, and more productively, given that he would have material to reflect on and work with. If you like that kind of therapy, to dissect what goes on between the two of you.

I’m sometimes 5 minutes late because I’m coming straight from work. She doesn’t really mention it. One time she did though because I was 10 minutes late. She wasn’t rude though just not very happy. I never cancel because I’ll be charged $70. Which equals to what about 5 sessions would normally cost. I think it’s unfair that I get charged yet she gets to cancel and I’m just supposed to be ok with that.

Does your T not understand that you are late because you are coming from work?

I just left my T’s office. We talked about my canceling last minute for one of my appointments last week. I was stressed about his response but didn’t need to be because he might be the most understanding human ever. He said he missed me. He also said he thinks it might just be that I felt I shared to much the day before and felt that was enough. He said he would still encourage me to come in and talk about that, but I don’t need to if I don’t want to. In the bigger context of being a bit of a perfectionist, he talked about how we are both imperfect people and will make mistakes. He will try not to make mistakes with me, but he likely will and we’ll talk through it. Maybe he won’t respond to a certain email and I’ll feel neglected or maybe he will respond to an email and I’ll be triggered by it. He said it’s messy and we’ll talk it through those things. I was pretty quiet in session, but as I drove home I had tears streaming down my face. My childhood would have been so much easier if my parents had that attitude.