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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shit day at therapy

i hate when i leave therapy feeling worse. usually, there is a feeling of relief and safety. not only am i able to speak to someone who understands and does not judge my irrational ways, but that i know cares about me, believes in me, and is there for me. but that didn’t happen yesterday.

she was gone on vacation last week and i only see her once a week now. it felt like forever. throughout the week i wanted to call her – that dependency scares me. it was a bad week for her to leave since i was still having after-effects from the klonopin disaster and had had a few close calls.

i brought up yesterday that i feel like big issues come up and we table them but we never actually get to them. i think i had brought that up six months ago as well. that’s mostly me – i usually come in there like a whirlwind just spewing the latest drama of my family or school or friends. but as i speak of the week, my issues with sexual trauma, self-esteem, boundaries, loneliness, sense of self and purpose continue to come up. and we say “yes that’s something to explore” and then i continue with some inane decision i have to make.

i asked her about it yesterday and she said that she just didn’t want to make me talk about something until i brought it up and was ready to go into it. i dunno, maybe i need to write out a list so i have a better sense of the things that ruminate in my mind all day and that i catastrophize at night. can you go into therapy with an agenda. “today we shall talk about your issues with men. and…go!” But at the same time, i kind of want to scrape at these now, in a safe environment, before i go to london.

the point is, listing the things i wanted to work with and then leaving, i just felt awful. i told her that while i understood that these past few weeks i was clinically unstable, the ideas in my head weren’t invalid. the intensity of which i handled them were – leading me to very dark places. but they are still truths (not facts) in my life. and even feeling better now, they’re still there, taunting me from feeling confident in decisions or in waking up feeling safe in the morning.

when i was clinically depressed i was exhausted all the time. the sadness tired me out, and the pain, both emotional and physical would wreck me. but i’m still exhausted. from my nightmares and anxiety dreams; from my self-doubt and fear of the future; and the idea of what’s next – be it next year, next month, next week, next day, or the next few hours. the problems are still here and i felt like i opened a box of fear and sadness, time ran out, and i was left in my car driving home, thinking of all i have yet to approach.

i hate shit days at therapy.

Self Mutilation: An Ugly Tattoo of Hate & Shame

Disclaimer: Let me first say that cutting, or “self-mutilation” is a horrible thing and I do not condone it in any way. I do not think it’s helpful, actually works in the long-term, or is a worthy form of positive self-medication. I’m also not going to go into details about how I did it or where I did it, because I always found that when I read about it, it was like a how-to with tips, and that’s not my intention either. If you find yourself cutting, you should seek help – whether by telling a friend or family member; finding a support group; seeking out a therapist; or calling a hotline. And if you are someone who is told that someone you love is cutting, the best thing you can do is ask them how you can help.

That being said, for me, cutting was a self-medication I began my sophomore year in college (see post on self-medication for background.) I will say that when I started, I was at a point where I felt like I was going to explode inwards. My pain was so severe and nothing seemed to dull it. I physically felt like I was throbbing with pain and bloated with agony. I imagined myself like a balloon that had too much air in it and needed a release. And that’s what cutting did. It was like I was letting a little of the pain out psychologically by creating a hole physiologically. The release never lasted more than 2-5 minutes and then the shame of having hurt myself plus now having to hide it led to other negative self-medication like binge-drinking and eating. But sometimes, it just led to a good cry. Not even a cry – a good all-out sobbing. And now I realize, that’s what I really needed and what felt so good. It wasn’t the cutting. It was that I was feeling so much I felt nothing and the pain of the cut allowed me to feel and then brought all of my emotions to the surface.

Like most self-medications, I became addicted quickly and learned how to hide it. Now, in retrospect, I think a part of me always wanted someone to see it. It was like I was waving for someone to help me from a sinking ship by flashing a part of my skin that hadn’t healed or accidentally showing a band-aid with hopes someone would catch me in a lie.

I also was struggling with some family issues at the time and was frustrated that I thought no one in my family understood my pain. As a child, I was deemed the sensitive, empathetic one. (And to be fair – I really was and still am.) But I had tried to explain to my family that something just wasn’t right since I was little. They would check my forehead, tell me I was hormonal, or just tell me I was taking things too seriously. By high school, that’s when I stopped complaining as much and took matters into my own hands. From my perspective, my family was too busy living their lives to see my pain and I was in this alone – the odd one out that never belonged there anyway.

And so perhaps a part of me cut because I wanted to hurt them and I wanted them to see my hurt. I wanted to make them believe my pain was real and not hormonal. I was sick and I needed them to see it. And so, after a few years of cutting, with some therapy to boot, I told my family. I want to say I felt sick seeing how it hurt them, and given my love for my family, it did. But it also made me see in their pain, their love for me. I know they have always had it, but I never really saw it, and I guess the cutting opened up that opportunity for me.

I’ll never regret the process of self-medicating. It’s what made me realize I needed to accept support from others, to get on prescription medication, to change my lifestyle, and eventually to get ECT. I still have the random bender where I cut, but it’s different now. The high doesn’t last, and I know now I’ll need to tell my family and I’ll be ashamed because I know how much time and effort and faith they put into me. I know that they themselves deserve more from me, and so do I.

Self-Medicating: How Can Something So Right, Be So Wrong?

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Mental illness or not, we all do it. No, I’m not talking about masturbation – I’m talking about self-medicating.

Life is a stressful, complicated, big blob of fear, anxiety, and failure, wrapped in a bomb with an unknown time limit before explosion and death. It’s no wonder people need a way to relax.

For some, they go the way of meditation, aromatherapy, yoga, acupuncture, natural and prescribed medications, exercise, and healthy eating – and I am in no way knocking these things. In fact, I have tried, and am doing, the majority of them. But sometimes, it’s not enough. And especially if you working with the complexity of life and a mental illness, it can be too much to balance with breathing exercises and a downward dog. Besides, medications are expensive and as I mentioned in my last post, take time, are unreliable, and have major side effects.

So we try to self-medicate first. For me, it started with food. I could stuff myself with food and just before I thought I would throw up, stuff myself some more. Then, by the time I got to high school and was constantly trying to lose weight, it became anorexia – trying to see how little I could eat to see how much control I could gain. But there was also alcohol and drugs. And it’s not like someone was asking me if I was okay because everyone was doing it, it never impacted my grades, I never got busted, drank and drove, or made those mistakes that some Beliebers do.

In college, I would outdrink the guys next to me and then make out with a few – trying my best to convince myself I wasn’t the ugly, worthless piece of shit I knew I was. It never quite did the trick and since I was too much of a control freak to sleep around, I started to wonder how I was going to find my release.

Somewhere around sophomore year, I found cutting, or as some call it “self-mutilation.” It was the best of times; it was the worst of times. It was the point I realized I needed therapy but it was also when I finally found a self-medication that did what I needed. I’ve tried to explain cutting to many, and I’ve learned from others that like most things, it’s different depending on the person. But I can tell you what it gave me, and why to this day I still miss it. But more on that later.

I know people self-medicate in different ways that take them on much more intense addictive paths. These paths exacerbate their psychosis, and can lead to, for example, homelessness, violence, and abusive relationships. While I know that prescription medications are not a cure-all (I’ve been “unlucky in love” with most of mine,) I think the difference is that self-medication is a short-term fix while medication and therapy seek to find a long-term solution. And given how exhausting this process is, I think the latter is what we’re truly looking for on this journey.