Breaking Up Is Hard To Do: The Process of Leaving A Therapist

I broke up with my therapist on Friday.

It’s my first real break-up (with a therapist or a partner). I’ve had relationships end with therapists in the past, but I either had to move to another state or did not like them and ended up “ghosting” them, allowing the relationship to die in absentia.

Nothing went “wrong.” We had been through a difficult period recently because my meds were off and I was in a deep, depressive state. Generally, I find therapy irrelevant when I am in a depressive episode because I don’t care enough to want to get better. We were struggling to try and keep me moving forward in my planning until my meds could eventually be sorted. But we had been here before in the two years we’ve been working together. That wasn’t why.

She has been away for two and a half weeks, and in that time, my psychiatrist and I have tried some new things, one of which seems to be working. It has made me feel stable enough to feel ready to take a step forward. I need to start volunteering, having informational interviews, and making tangible decisions to help build my life.

I believe the most effective way of taking that step is through DBT. It will help in creating goal-oriented behavioral techniques. I might be completely wrong, but it seems to be a good fit by helping with my interpersonal effectiveness, emotion regulation, and distress tolerance, while I take some terrifying initiatives. While I have done DBT modules and a little bit of coaching, I have never done DBT therapy. You legally aren’t allowed to see two therapists, and honestly, I can’t afford both of them. (Interns can still cost a pretty penny!)

I didn’t know when I was going to do it – tell her I wanted to stop. I thought I would chicken out but realized it would be silly to continue to see her for a few weeks, knowing that I was going to leave. I decided to see her last Friday and tell her then. I practiced how to say it on the car ride over – it never sounded right. But I somehow got it out.

She was proud of me. Two years ago, I would have never been able to tell someone something they didn’t want to hear but that I wanted. And honestly, she is a large reason that I am able to do that now (on certain occasions.) We discussed having a few sessions to deal with leaving, but I just needed to end it. She told me that her door would always be open – if it didn’t work and I wanted to come back, if I just wanted to do a bi-monthly check-in, or if I just needed a session to talk. She’s that awesome.

She asked me a few questions about what I thought I got from therapy and things I wish could have been different and then said some incredibly kind things. I knew I wasn’t actually processing any of it. I felt like I was watching it happen, almost like a scenario acted out in a dream. She opened the door at the end of the session and she said “Goodbye Ava.” No, “Have a good weekend and see you on Wednesday.” Just “Goodbye.”

It doesn’t feel real. As things occur each day, I think of telling her. I keep thinking I will see her Wednesday and tell her about an email I got from a friend and we will discuss my anxiety problems with money. But I won’t. The only comfort I can find right now is that after two years of working with her, I can almost hear her response when problems arise. I know the questions she would ask. The way she might challenge my assumptions. She has left an indelible mark on my recovery and in how I am learning to see my world.

In the car, I tried to quell my oncoming tears by acknowledging that we lose people all the time. I left all my friends. I didn’t “lose” them completely, but they are not able to be what I need anymore. People have died in my life. Stopped calling. I have had a loss, though I appreciate the difference in each, including this one.

I wonder when my brain will fully acknowledge this loss. Right now I find myself scared. I don’t know if I made the right decision or if I made it from the right place. But I know it feels right and while it may change things, for good or bad, she would want me to follow my intuition. Maybe I can hang on to the fact that it might just be a trial separation; that I can always go back if I need to. I try to remind myself that I was supposed to be in London today, unpacking and preparing for school, and I wouldn’t have seen her for a year.

So many people do not believe in the benefits of therapy. Others go once, do not like the person, and never give it a chance again. But some of us, if we’re lucky, get the unique experience of an objective, supportive, non-judgmental, safe person in our lives, that help us organize our racing thoughts, grieve our trauma and lost chances, help encourage our change and growth, challenge our misconceptions, show us glimpses of ourselves we cannot see, and sometimes, if they’re really good, gain our trust to help us believe we can have hope.

I will be forever grateful for the time I have had with my therapist, even if it’s not the end of our relationship. But if it is, I walk away with a better version of this “self” I am creating, because of her.

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The Blame Game With Mental Illness

[Trigger warning: Mention of self-harm]

I met with my psychiatrist last week and told her that I have been feeling worse but I was worried that maybe it was my fault and I was somehow doing it to myself. Well actually, I started to say that and she cut me off right at “maybe I” with a sharp “No.” After apologizing, she told me that I have to stop blaming myself for my depression.

People can undoubtedly lie to themselves. For example, someone with an addiction tells him/herself they don’t have a problem and they stay in denial that their actions are negatively impacting their life. I get that. But can you be lying to yourself if you are asking yourself if you are lying? If the idea of denial in the example above is to convince yourself you do not have a problem, what is it if you convince yourself you are trying to convince yourself that you DO have a problem? Can you accuse yourself of having a derivative form of Munchausen Syndrome?

It’s an odd thing: the idea that I am purposefully making something worse; that I am sabotaging myself from recovery by somehow forcing myself into depression or not fighting as hard as I can. I interrogate myself: Is it really just fear and weakness and not a “disease” at all? Could I try harder, do more, stop whining? Do I just need to have the will and gumption and am too meek to face my reality? Am I somehow lying to myself?

But there is a part of me that knows that this is real. That leaving a job I was proud of, friends that I loved, and a life I had built wasn’t just for attention. Lying in bed in for weeks, crying for hours, choosing to have ECT, well that would be one hell of a con. Perhaps at the core of this questioning is an insecurity, hate, and long-developed distrust of my thoughts and feelings.

This doubt of my own feelings was developed over time and starts in my younger years. I was constantly told I was too sensitive. It wasn’t intended to be an insult, but it also wasn’t always used in a positive context. Rather, it was often noted as the cause of my intense feelings of sadness over anything that was bad. In defense, I was incredibly empathetic as a young child. When I was five, my mom had my dad change the mailing address of the newspaper from our house to his office, because I would read the paper and cry about all the horrible things happening in the world.

I hoped to find something physically wrong with me that would provide tangible symptoms to explain why I was like this. I remember feeling relief when I became sick – whether it was a cold or ear infection. Because when I was “sick,” I knew those around me believed my pain. And it wasn’t my fault or something I was failing to fix. 

There was always a rational reasoning for my behavior: in grade school, it was that I was being bullied; in high school, it was hormones. The darker melancholy that was growing inside me was overlooked because I didn’t believe it was legitimate and therefore never mentioned it. I assumed my constant complaining was indicative of a selfish, childish, and  weak personality defect. When bad things happened, I began to question if the amount of pain I felt was fair. Was it really that bad, or was I making it worse? Maybe my feelings were being manipulated by my selfishness?   Did I have the power to stop it?

When I got to college, I still blamed myself for my thoughts and feelings. And that’s also when I discovered self-harm. While there are many reasons why I self-harmed, I think one of them was having something to show for my pain, and it helped me feel better about my sadness. Still, I continued to chide myself for feeling sad all the time – I needed to get over myself. Other people didn’t have ideal lives and they were managing, so why couldn’t I? I still find myself asking that question.

The real problem is that even if I could convince everyone around me that this isn’t my fault, I can’t fully convince myself. In my mind, every time I cancel an appointment; take a pill for my anxiety; cry hysterically for no reason; not feel any different when starting a medication; or start to feel bad on a medication that seemed to be working for a few weeks, I worry it’s something I’m doing wrong, not the depressionMaybe it’s my fault that I am a burden, and maybe it was somehow a choice I made – though why – I cannot figure out.

And yet, I also know that this isn’t me is because I have experienced what it is like to have clinical depression lifted. When I found the medical concoction that stifled my depression about two years ago I felt so different. While I was tempted to sometimes cancel because I was scared or maybe just out of habit, I didn’t. When I was feeling anxious, I went to the gym because I knew it would help. Sometimes I would have weeks where I was exhausted from trying to change my habits and face my fears, but it all still felt possible and I wanted to try. The difference in how my mind worked was so clear. I had been functioning within this cloud of depression and it was the cause of my actions and reactions.

I know that while depression feeds off itself, it’s not me feeding it. I’m not giving in because I want to, because honestly, I really do want to be able to get up in the morning and be an independent person who can make it to work, handle responsibility, and rebuild my life. Perhaps the fact that it terrifies me to think that I could be doing this is enough to know that I’m not. But that’s the thing about depression. It wants you to blame yourself. It convinces you that you are the cause of everything bad in your life, even if it’s irrational. It tells you that you are the way you are because you did this to yourself. It tells you to stop blaming some “idea,” and take some control over your life. Then it laughs at you when you try and fail.

I just have to keep telling myself that this is the illness. This is the lack of chemical reactions and electrical signals in my brain. This is not something I can control. And this is not on me. There is a serious problem, but it’s nobody’s fault…or at least nobody’s choice.