Ending and Unending Part 1 of 3

Two or three times a year, I’ll unwittingly schedule an initial consultation with a potential client who reveals that they are “thinking of leaving” their current therapist – and are meeting with me and several other clinicians as they shop for the quickest exit strategy.

Here is the deal: if you’re single, it’s not a great idea to date someone who is going to leave their partner any minute now, but just hasn’t told them yet. And it’s not a great idea for me to take your case when you are in an active relationship with a clinician who has committed to working with you, but hasn’t been told that it’s not working.

So: how do you know when you should break up with your therapist?

Unless there are some shockingly obvious ethical violations involved – in which case you are permitted to head for the hills without looking back – the answer is very simple:

Talk to them.

Ridiculously obvious advice about how to use the talking cure.

You may feel that the therapy has reached a state of impasse right at the edge of a wonderful milestone, a fantastic accomplishment: the moment when it is discovered, with absolute certainty, that you know more about your own needs than the therapist does. Many people become fearful or disappointed at this crossroads – certain that their therapist will feel diminished, injured, enraged, or may never be able to be of use to them again.

We all just prefer to have our minds read, don’t we? We don’t want to have to explain all the time. We want our partners, parents, and friends to guess exactly what we want for our birthdays. And we want our therapist to just “know” what makes us sad, upsets us, what we need from them. Why on earth are we paying them if not to be understood – magically, instantly, completely and without having to explain a thing?

If we have to tell someone what we need – or say that we don’t know what we want but are pretty sure we aren’t getting it – well then, it just ruins things somehow.

It disrupts the illusion that there is any way (after two years of age) to have our un-verbalized needs read and met by huge, magical, intuitive all-loving parents. And part of us thinks that should be quite doable somehow; because there was, in fact, a time in our lives when our needs were quite simple: food, human contact, sleep, diaper change. Simple needs, clear clues, good odds (1 out of 4) of getting satisfaction without having to say a word.

Subsequently, in adulthood, we all occasionally feel terribly, unduly burdened:

1) We first have to figure out our own complex, mature, interpersonal needs –

2) Then formulate a plan to take responsibility for them ourselves –

3) Next, we have to ASK for the need, or some part of it, to be met and cared for by others

4) We then have to weather the disappointment of rejection or the mere partial fulfillment of our needs –

5) Worst and last: We are then left to cobble together some plan to take care of the leftover hunger on our own.

Too, too many steps: It would be so much easier if our partners, care-providers, healers, loved ones, bosses, shrinks – would just guess correctly and spare us all that work.

Often, clinicians/therapists can be pretty good guessers. The more intuitive and experienced they are, the better they are at seemingly pulling our most subtle needs out of thin air. Still, they aren’t magicians and – even if they were – at some point they will need to start failing, or just stop guessing because it doesn’t serve our process of growth to keep waiting for the grown-ups to show us what we want. Our needs are our own responsibility to negotiate.

So, you have to talk to your therapist about your dissatisfaction even if you don’t like them very much right now. Even if you know they are limited, haven’t been of much help, or will never “get you.” Even if you know that you have made up your mind, like them well enough, feel they have done their best by you, and you don’t want to hurt them.

Even if you dread it.

Tell them you are unhappy or dissatisfied with the course of treatment, that you don’t feel sufficiently challenged, supported, listened to, pushed, understood, whatever.

Tell them.

You will learn a great deal about the viability of the relationship from their response. If, as you fear, they become defensive, angry, anxious, injured, avoidant, accusatory, or calmly and completely blame only you for the relationship’s failures – that is in itself very important data.

Perhaps this is not a good fit. Perhaps you are activating some counter-transferential difficulties for them that makes it hard to respond due to their own history and their own wounds. Perhaps they are narcissistically attached to being right, to giving you advice, to your dependency on them. Perhaps they are extremely healthy, excellent at what they do – but they are loyal to a model that you don’t find useful.

Even if it’s a total miserable dead-end, you will get to leave clean, like a grown-up, making a self-respecting choice, after eliminating any doubt that you could have worked it through.

You will also have seized a great opportunity to create a corrective experience: what if the “no-longer-good-enough” therapist displays sincere interest in your “bad” feeling? What if they are pleased to have the opportunity to grow, to change, to accommodate, to learn more? What if they deeply yearn to take responsibility for errors and mis-attunements they may have committed? What if they can apologize, and take their share of the responsibility without collapsing in shame? What if they value your feedback because it will give them information they don’t know, maybe even information about themselves of which they were unaware? What if they are grateful to you for showing them an unknown bit of their shadow and giving them a chance to integrate it?

What if they treat your concerns, your anger, and your disappointment as if they are important and valid? What if they have enormous empathy for the hopelessness that has emerged in your relationship? What if they can still care about you and remain intact in themselves, in the face of your negative feelings? What if they have felt blocked and frustrated as well but were not yet able to identify it? What if this discussion is able, in and of itself, to break through the logjam?

Even better: What if they are proud of you? Impressed by your self-regard, and your ability to stay loyal to your own experience? What if they want to help you keep strengthening this newly discovered muscle?

What might that mean to you?

Or perhaps they can at least agree that the clinical relationship has not been a good fit, and the therapy can end honestly and mutually? What if they can release you to a new scenario, a new therapist, and still feel proud of whatever you were able to accomplish together or the integrity that you both showed at the resolution of the relationship?

What if you don’t need to protect them from your feelings, needs, wishes, desires?
What if you never did?

I’ve been in many relationships, personally and professionally, where the greatest growth came from the way we left each other. The real failure is not the necessary ending of a therapeutic relationship; it is missing out on the opportunity to be further healed by leaving well.

copyright © 2011 Martha Crawford