My aim as a therapist is to become redundant as soon as possible, and to have been a catalyst for someone becoming clearer about the reasons for their difficulties, the effects these have had upon their life, and most importantly, what they can do to change them.
Some therapeutic approaches assume many months or years of attendance to explore the furthest corners of someone’s psyche – but who (other than a trainee therapist of such an approach) has the time, inclination or money for such extended and extensive therapy?
I once met a therapist at a conference who proudly said that he had clients working with him for between 10 and 17 years (and that was a few years ago – so perhaps they’re still there!) In such cases I wonder what the therapeutic aim and purpose is, and where the responsibility and integrity lies for ending what must have become an emotional dependency rather than a therapeutic relationship.
There are many reasons for therapy to end. The best one being that the client has gained what they came for and can now go back out into their world with more self-awareness, understanding, self-compassion and the all important life and relationship skills that will help them to attract more love, peace and vitality into their lives. Emotions and moods are also better understood, moderated and expressed appropriately; self-esteem is more robust and resilient; boundaries are clearer and actively maintained; past hurts, disappointments, traumas, shame, losses and regrets have been aired and no longer sap the energy or control the mind; and relationships are more mutually rewarding and enriching – one person can change a relationship by behaving differently and causing a ‘ripple effect’ of change in others, and this is set up and modelled in the therapeutic relationship
Occasionally a client will just stop attending without any explanation – despite attempts to reach them. These are always a mystery and a sadness because there is a huge missed opportunity to grasp the real ‘issue’ for them and work to resolve it.
Sometimes the ‘fit’ between client and therapist just isn’t right and a client may blame themselves, ignore their intuition and gut feelings and soldier on for a while until their inner voice gets too loud to ignore, and they may then have the awkward task of explaining why they want to leave (or they may instead just tell a lie and say they are ‘better now’ or ‘all sorted out’).
‘Therapeutic ruptures’ can also result in the end of therapy. A mistake has been made by the therapist and the client then feels too uncomfortable, perhaps feeling overly exposed and vulnerable; maybe they feel misunderstood or judged by an incompetent therapist. Paradoxically, if these ruptures can be worked through they can really deepen the relationships and allow for more real human contact – if the therapist is willing and able to work in this way.
I’ve had a few clients end our work not of their own free will – but because a partner/spouse or parent was paying for the therapy and they weren’t happy that the client was indeed changing, but not in the way they (the person funding the therapy) wanted! Maybe a wife or teenage child was becoming more confident, assertive and expressive – and this went against the wishes of the one holding the purse strings!
More obvious endings result from the client changing work patterns or location; or they can no longer afford therapy; or they have made some significant changes and say that they want to put these into practice and perhaps come back again later for more therapy – which rarely happens, and instead becomes the ending.
How long someone is in therapy for depends upon how much of a crisis they are experiencing and how immediate their needs are right now; how much time and effort they are willing to put into attending and making the most of our work together; and how much they can, or are willing to, afford to spend on themselves. I’ve had a few clients who were wealthy by ordinary standards and yet ‘couldn’t afford’ to spend money improving their lives through therapy – and instead just bought more ‘stuff’ and went on more holidays; or consumed more food, drink or drugs to get a quick fix! Ironically this becomes a much bigger waste of their time and money, and makes matters worse.
The best endings are planned. The ‘yardstick’ is to work towards an ending for one month for each year someone has been in therapy… but I don’t like yardsticks. Ideally we will both agree when it’s time to end, and what we will work with in the time remaining (although I always have this is sight from the start, and in each session – as I don’t make any assumptions, or draw up any contracts, about how long we will work together). New clients often ask ‘How long will it take’? but I don’t see how we can know in advance how long someone will need in order to get what they want, and can manage and make best use of. It all depends upon the presenting issue and the deeper underlying issue(s) – which may or may not be exposed and worked with.
Some clients have given me a gift upon ending – an exchange of energy. I was told early in my training that more ‘traditional’ analytical therapy approaches recommended refusing any gift – and even deliberately breaking it in front of the client if it was breakable…how inhumane!! Needless to say I’m not in favour of such cold and disrespectful ways of working or ‘non-relating’. In fact I think they are counter-productive and destroy the potential for experiencing a real relationship with a therapist which can then be a template, or a rehearsal, for what the client can recreate outside the therapy room.
Nowadays I am busy promoting my two new approaches to overall well-being – ‘The Ripple Effect’ Process and Quantum Psyche Process; and so I tend to see very few clients, and for only one or a few sessions. I can work in a short-cut way and be a catalyst for more direct insight and change – which suits us both. That is what I have wanted recently, and I’ve attracted a few clients who also wanted this approach too.
Fear of reverting back to old behaviours is often raised at the ending stage – and is a valid fear. Back in the home, work or college/university environment it can be hard to maintain the new way of being, as other people try to mould and manipulate you back into what they want you to be, and what best suits their needs. This is particularly so when working with children who are powerless to change such circumstances of their lives.
Casting off an old behaviour such as self-harming or gambling might only result in the emergence of another way of expressing a deeper sub-conscious pain – which may then take the form of anorexia or promiscuity for example. A decision has to be made about whether the ‘ending’ can be postponed to allow for more work on the newer problem – and a deeper exploration of the ‘real reasons’ for the behaviours.
This is why I created QPP – to rewrite the subconscious SCRIPT (Sub-Conscious-Rules-Influencing-Present-Time) which can be glimpsed, but not changed by talking therapies, willpower or intention alone, and yet runs our lives over 90% of the time, setting up our outer circumstances to be a reflection of our deepest sub-conscious belief system.
Sometimes it’s just too hard to say goodbye, and the ending is avoided altogether. A few years ago I had a long-term client – who always wanted/needed to pay me in advance for several sessions at a time – just not turn up for the last one, where we would have had to say our final goodbyes. Ironically this means that there is still more work to do but the opportunity to look at actual ‘endings’ has gone.
How can someone tell that the therapy has been worth the time, money and effort – where’s the proof or evidence?
It comes in a happier, more balanced life, attitude and emotional responsiveness; a life lived with courage, confidence, compassion and love; an undoing of the emotional knots of childhood and a soothing of the scars of more recent battles; a finding, befriending, loving and taking compassionate care of the self, and to know that the self is always good enough and can always be relied upon when needed. Endings can then signify new beginnings.