The importance of therapeutic endings

Abridged version from 21 Rules for Success in Therapy (Rule 18).

In reading this article, perspectives in favour of having an ending time with the therapist are given. However, you should only do this if you’re ready, feel safe and importantly, if you wish to. You are free to choose how to end.

As soon as therapy begins, there will eventually be an ending. In this rule you will learn about the therapeutic potential of endings, when to end, and various perspectives on client-and therapist-initiated endings.

In this rule you will learn:

  • How endings can be therapeutic.
  • Several perspectives on the question of “when to end?”
  • What you can reflect upon during the ending phase.
  • Perspectives on whether to end silently or not.
  • Perspectives on therapists initiating the ending.

For perspectives on client initiated endings see Rule 20: Don’t walk away without talking to the therapist.

Endings as therapy

What if you had to stop a really good film before the ending?
What if you listened to your favourite piece of music and stopped it in the middle?
What if you watched an exciting sporting competition but never knew the result?
How would you feel?

Now. How would you feel..
If you never got to say what you wanted to say to someone you cared about?
If you never got to say how someone hurt you?
If you never got to say goodbye to a friend?
If you never got to say goodbye to someone who supported you?
If someone you loved said they wanted to say something important, but never got a chance?

Would it bother you? For many people the answer is yes because these situations are all to do with facing feelings, issues and concerns. But for others the thought of endings can be painful, scary and an anxiety-inducing experience. Ending may be embraced, or avoided, feelings expressed or left unsaid; either way endings will happen whether or not we choose to experience them directly.

The prospect of ending, whether imagined or initiated by you or your therapist can bring to the surface a variety of feelings. Here are some possible feelings as you contemplate endings:

  • I will know when to end.
  • I’ll feel indifferent to ending.
  • I’m anxious the therapist is going to dump me.
  • I didn’t like what the therapist said so I’m going to end it (whether imagined or followed through).
  • I want to leave but I don’t know how.
  • I don’t know what I’ll do without therapy. I’ll really miss it.
  • I don’t want this relationship to end. I’ll really miss my therapist.
  • I don’t know if I’ll get more from staying or from leaving.
  • Should I leave this therapist and try another?
  • I would feel guilty for leaving, especially after all the work we’ve done.
  • I don’t want to leave my therapist because they’ll be losing an income stream
  • I am scared of losing my therapist. Last time they were late, I nearly had a panic attack.

Therapists are typically taught to keep endings in mind during the process so that they can be aware of your needs, and so that you are ready for it when it arrives. However, you can also help yourself by airing your feelings about endings during the process, or when you’re thinking about initiating the ending. Feelings about endings can interfere with your process or they can be used as an opportunity to catalyse it. For example, if you imagine the therapist is going to “dump” you, it could be a hindrance in therapy because you aren’t able to be yourself, or it could be an opportunity for exploration if you’re struggling to find your authentic voice.

Endings are not separate to therapy: they are therapy. Your feelings, or even lack of feelings, and how they relate to your past can all be used therapeutically. Thinking about endings is also a way of determining whether you are really ready to end.

Experiences of endings

Your life experiences of endings can also be another therapeutic source to explore. You can reflect upon your experiences of endings and how you have dealt with them.

Here are some examples of life experiences related to endings:

  • My husband left me and my children for my friend.
  • I had a miscarriage. This is my fifth.
  • We lost our family home.
  • I usually slip away quietly at the end of a training course and don’t like to say goodbye.
  • I have lost all my family and friends now. I am the only one left.
  • My father abandoned me when I needed him.
  • I always say goodbye after meeting people at the end of a training course and make sure I take some contact details.
  • I can end easily, sometimes I think too easily, without much reflection, even after years of knowing someone.
  • My two brothers died in the space of six months.
  • I am used to people leaving me.
  • My friend passed away and I wasn’t allowed to attend their funeral. I vowed never to have a best friend again.
  • I’ve left the life of a bachelor behind.
  • I saw my dog get run over and he died in my hands.
  • I loved to dance but after my injury I couldn’t dance again.

By reflecting upon your experiences of endings, you can understand what they mean to you: your underlying beliefs, and how you would have liked endings to happen, including therapy. It is not necessary to have a particular concern about endings, but it may increase your self-understanding about how you work and why.

When is it time to end?

A common theme linked with endings is not knowing if it is the right time to end. Sometimes you end for rational, well thought-out reasons, such as you don’t feel the therapist is right for you, you feel worse or you’re just not ready for therapy. Whenever you decide to end therapy, regardless of the reasons, you can reflect on your reasons or talk with the therapist (See Rule 20: Don’t walk away from therapy without talking to the therapist).

But when is it time to end in the recovery phase of therapy? You know you have improved, even beyond what you thought achievable, but you can still be left feeling confused, guilty, or even anxious about whether to continue or to end.

Sometimes it can be about the transition out of a good relationship, or you feel you may still need the therapist; after all, what if your problem or symptoms return? Other times, it could be that you’ll miss having a space in which to be heard.

I would suggest giving yourself time and space to work through these feelings, ideally with the therapist, and then eventually you will be able to answer the question of whether you are ready to end or not.

A common strategy used to test out whether you are ready to end, is to allow more time between sessions, reducing session frequency and taking a break for a few weeks. If you’re worried about needing the therapist you can ask about their policy if you need to return. You’re likely to find that therapists, particularly in private practice, will welcome you back as long as they have availability.

Ultimately, if you’re not sure, or you have strong feelings about the ending, then that can be a sign you’re not ready and need to do more work before making the decision to end.

The end

If you’re ready and feel safe I recommend a defined ending stage with the therapist, regardless of whether you or the therapist initiates it. The ending stage could be for five minutes, a single session or many sessions over months. If you’re not used to experiencing endings, or are used to bad endings, this is a chance to change that history. An ending can be therapeutic, because it’s an opportunity to say what you feel, what the ending meant and to gain closure.

Here is an example of feelings experienced towards the end:

I feel excited, nervous, happy, and a little sad, but because of therapy I can cope with them. I’m a little sad because it feels like I’m losing a friend. I’m nervous because I don’t know what the future holds. I’m also happy that my leaps and gains are far more than I could have ever hoped for. It’s time to trust myself and try on my own. It’s the beginning of a new chapter for me.

Here are some ideas for reflection during the ending stage of therapy:

  • Your readiness to allay any concerns you may have about ending.
  • Your journey, such as highlights, lowlights and turning points.
  • What you found useful or not during the process.
  • Your previous experiences of endings in contrast to the therapy ending.
  • What if feels like to end the relationship with the therapist.
  • What your plans are after therapy.
  • What your learnings were during the process.
  • What else you would like to work on.
  • How you like to end things.
  • What this way of ending feels like.

Endings, especially if you have a strong relationship with your therapist can be emotion filled. However, by the end you should be ready to move to your next stage, either in life or even to another therapist. If you feel like it’s a milestone then celebrating the ending together can be a gift.

Scenario: Client ending silently

You can end silently if you wish, without talking about endings. It is not that uncommon for people to stay silent about their plan to end, even if it feels like they have achieved their aims.

Here is a way of understanding silent endings from a therapist’s perspective:

A client had been seeing me for a number of months. I felt the relationship to be good and he said that he was starting to feel better; it felt like an ending could be on the horizon.

For a number of weeks he sent me a text messages asking to rearrange planned sessions to which I replied with possible options. However, I noticed after a few weeks, there were longer time spaces between messages and eventually, after a few times trying to arrange a session, messages stopped coming in altogether. He ended silently; the messages just stopped coming.

From my perspective, he has autonomy and freedom to choose the ending. It is what he needed at the time—he got what he needed and ended silently, I wished him the best in my heart. I also wondered why he felt the need to silently end. I reflected on the multiple losses he had suffered in his family recently and whether they linked to not wanting another ending, however positive. I would never know for sure. I also wondered whether he had ever felt a need to end, or even whether he had good role models that showed him a good “goodbye”.

The other part of me wondered whether it would have been something to explore, as part of his process. His need was to end in the way he did; as a therapist, this wasn’t about my needs.

This example demonstrates two differing perspectives: a reason for ending silently and a reason for working actively towards an ending.  Maybe the client felt he did not want to go through another ending given the losses he had suffered, and the therapist wondering whether a process of ending could have been another way of mourning the losses, or experiencing a better ending in order to celebrate and say goodbye.

There is no right or wrong answer, it’s about what you need. You decide.

Ultimately, unless the therapist initiates the end, you’re free to choose to end—for the reasons you believe are right and in a manner which you feel is suitable. You should not feel you must have a formal ending—one in which you say goodbye. It’s not uncommon for clients to decide to leave without really saying why or to feel they need a formal ending.

Unless safety is an issue I recommend you don’t walk away from therapy without talking to the therapist

When you initiate an ending with unresolved problems, unless it will cause harm or you’re not ready, regardless of the reason for leaving, always work through your feelings, thoughts and decision process with the therapist first.

In this rule you will learn about the potential upsides of talking to the therapist whenever you wish to initiate an ending, especially prior to leaving with unresolved concerns. In particular, you will understand how conflicts (sometimes called rupture and repair) in the relationship can—if handled well by both you and the therapist—be of enormous therapeutic value.

You may decide to leave therapy for any number of reasons including:

  • You feel worse.
  • You’re not ready or therapy is not for you.
  • You feel the therapist may be thinking badly of you.
  • You don’t want to be rejected by the therapist, so want to end it first
  • You feel you don’t deserve to be in therapy any longer
  • You don’t feel connected to the therapist.
  • There is something intangible you don’t like about the therapist.
  • You’re not improving.
  • Your ideal in how you envisaged the therapist and the process to be has not been met
  • You come into contact with new memories and thoughts which you are aren’t ready to bring into awareness
  • You don’t feel therapy is going to work for you.
  • The pace of therapy is too fast or too slow
  • The therapist said or did something you didn’t like.
  • The process of therapy feels threatening. For example, going to your inner feelings and experiences.
  • Life priorities and money.
  • Any number of other reasons described in Appendix D – Inventory of client concerns.

The objective in talking about your reasons to end is, of course, to learn something new. By exploring the end you can check out your feelings, see if the relationship can be repaired, check out the therapist’s perspective, learn a new way to deal with feelings including endings, and determine whether there is therapeutic value in exploring your reasons.

Talking to the therapist does not take away your decision and your freedom to choose. For example, the therapist may not be right for you or you may feel that their way of working is not suited to you. But by checking out your feelings, it could even accelerate your process or provide closure. If this doesn’t yield any benefits you have still learnt to speak about your feelings, and you can end gracefully. If a therapist is critical or does not accept your feelings it obviously confirms your decision to leave, so in that sense even a negative experience can be seen as an acknowledgement that your feelings are in harmony with reality.

Rupture and repair

Rupture is a term in therapy used to describe the underlying strain or breakdown in the relationship between you and the therapist. For the purposes of this section, I extend the definition to include a rupture between you and therapy, which is a felt internal threat from acknowledging your own feelings to yourself and the therapist.

In moments of rupture you can feel threatened by what the therapist does or says, or by the challenge of the therapy process. Ruptures may sit silent and unsaid, or they can burst out in the room through anger. They may even result in you walking out of the room. These ruptures are common in therapy and good therapists know how to work with you when they occur, because they know it can be a breakthrough moment in therapy.

Therapy, by nature, can be a challenging encounter even if you feel comfortable talking about yourself. There is a part of you which you have learnt to keep hidden, sometimes even from yourself, and this can be loosely referred to as the “inner child”, which is a symbol of your most important early development in life. This part can feel threatened by the experience of therapy for a wide range of reasons, which you may not even be aware of:

  • Feeling less powerful than the therapist. For example, less competent, or you feel they are viewing you through a critical or analytical gaze.
  • The inner part of you is threatened because it is never shown to anyone, let alone a stranger. Your internal parts feel under threat of shame at the thought of being revealed in the room.
  • The therapist may say something that pushes a button in you. For example, being belittled, not believed, judged, challenged or put under pressure.
  • Due to an injustice. This can come up if you believe the therapist is not being fair or sensitive.
  • Loss of control. Experiencing feelings where you say or do something that you regret. You feel you made a mistake and say something you feel you should not have said, either about yourself or the therapist.
  • A way of relating. For example, you become uncomfortable when the relationship with the therapist becomes closer. You feel exposed or are fearful that once you reveal the “authentic you” you will be abandoned or rejected. There is part of you that does not feel good enough in the relationship.

These threats can trigger in you the need to take control and power back from the encounter; this may be through abruptly leaving session, ghosting the therapist or even harshly challenging them. Here are some examples of the inner narrative of clients seeking to take control back from the encounter of therapy.

Tim was really silent in therapy. The therapist was tentative in the session; he did not want to rush his client, but he was not attuned to the fact that his client felt really uncomfortable with the long pauses. The client left feedback later by email that the therapist had “freaked him out” by being too silent.

David had cancelled sessions outside the 24 hour time limit. On the second occasion, the therapist reminded the client this had happened a few times. However, the client felt a sense of judgement and criticism, even though the therapist was highlighting boundaries. He never returned any messages and terminated three months of therapy.

Tina was feeling increasingly tentative about therapy; as she started to talk more about feelings about her partner and her relationship, the therapist noticed how her breathing would change, words would become slower and she would put a lid on it quickly with phrases like “Relationships are not easy.” She decided to end therapy by sending in an email after the session.

In all these cases, these clients did the right thing, which is employing their right to choose.  But therapists can make mistakes, and try as they may to reduce the possibilities of rupture, they won’t always be able to meet your needs because they can’t know everything (See Rule 19 for perspectives on therapist mistakes).  In Tina’s case she was clearly not ready to admit, perhaps even to herself her feelings about her relationship.

After a sudden relational rupture, it is possible that you will end the session immediately, and not return because you feel aggrieved, or because you feel embarrassed by your actions. However, a good therapist will accept your feelings and work with them, and while they may express their own thoughts, including their boundaries, they are there to work in your best interests.  Working through the impasse could be the most liberating part of therapy.

Another reason for ending without talking to the therapist is that therapy may be making you feel worse. Therapy is not always a straight line, nor is it a process without difficulties, so you may feel worse before feeling better. Feeling worse in therapy can appear to be self-defeating or hopeless, when in fact, it could be the opposite. For example, you may be edging towards facing feelings you are unaware of or mourning a loss. However, just because you’re feeling worse, or if more pain is being experienced, that does not imply that it’s healthy either. Talk to your therapist and/or physician if you have concerns about feeling worse.

Therapy is an opportunity to explore, perhaps for the first time, to check out your feelings and assumptions, by telling the therapist what you need or what is missing. Of course, none of this is guaranteed to repair the relationship or lead to further insights, but on the other hand, it may be the most important catalyst for recovery.

So if you are ready and it’s safe, don’t walk away until you have said what you feel and why you want to leave. Take a risk and say what you don’t like, even if you don’t know exactly why. Sticking around during the difficult periods to explore reasons for ending—even over a number of sessions—could be just what is needed to take your process to the next level.

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