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RSSIn my last post, I discussed how clients need to become emotionally dependent upon their therapists for psycho-dynamic treatment to be effective. How difficult the client finds it to tolerate his or her own needs obviously plays a major role in the development of that dependency. As I’ve said before, neediness is often one of the first issues we confront when we begin therapy: early experiences of untrustworthy or unreliable caregivers may have taught us that it’s unsafe to become too dependent, making us reluctant to “commit” to the psychotherapy relationship. These are ongoing issues that repeatedly come to the surface during treatment, especially around the therapist’s vacations, which often stir up abandonment issues or cause the old doubts as to the safety of the psychotherapy relationship to reemerge.
I recently returned to work from a 10-day vacation, and many of my clients had strong reactions to the break, none of them the same and each reflecting the person’s particular defenses. During my early years as a therapist, I found that I often lost clients immediately before and after my vacations; nobody decided to quit this time (with the possible exception of the client I described in my last post, discussed in more detail below), but there has been more “instability” in my schedule than usual — one session time “forgotten” by a client, some re-scheduling, emails expressing confusion about the appointment time, etc. This type of behavior usually (but not always) has a psychological meaning that you might uncover in the next session if you listen carefully.
In the weeks leading up to the break, sessions with one of my long-term clients had become quite lively in a way that was relatively new for her; for years, Janice had tended to a kind of psychic collapse related to her autism-like symptoms, where emotions and relationships tended to go “flat”. But in recent months, she has been becoming more “dimensional” and emotional. When I remarked to her early in one session that I thought she was very glad to see me, and also felt that I was glad to see her in return, she laughed in a joyful, embarrassed way. During the rest of that session, we often laughed together in a way that felt appropriate and affectionate, not defensive. This felt like a sign of progress to both of us.
In our first session after my vacation, she looked stony-faced and joyless. She felt that over the break, she hadn’t done particularly well, and we could both see how she’d retreated to an emotionally “flat” place. In a peculiar way, she felt as if she had no mouth (she told me), as if that part of her face had been cut away. The mouth expresses the earliest form of our needs — to be fed at the breast — and continues to stand for neediness throughout life, often on an unconscious level that shows up in dreams. Janice’s feeling that her mouth had been cut away shows how she has “gotten rid of” her needs, or at least the awareness of them. For people who come from families as disturbed as Janice’s, trust in dependency takes a very long time to establish and is easily shaken.
Alan, one of my newer clients, told me that he’d been incredibly busy during the entire break. Most of this busy-ness was inevitable, caused by the demands of his career; but telling me about it during our first session back, he expressed surprise that he hadn’t even set aside some time for himself during our usually scheduled hour over the break, hadn’t really thought much about himself at all. With a different client, I might have said that he filled up the gap left by my absence so thoroughly that he didn’t even notice I was gone, but that didn’t feel exactly right in this case. Alan is the sort of man who rarely depends upon friends and family, who other people usually turn to for help when something needs to get done; it would be more accurate to say that, during the break, he simply did what he has always done: avoided his own feelings and “got busy.”
Clients often begin to express doubts about the value of therapy just before a therapist’s vacation, or they come back for their first session afterward doubtful that they want to continue. “I’m not sure what I’m getting out of it,” she might say, even though she felt clear about the value a few weeks earlier. It’s a typical response to dependency and feelings of abandonment: I didn’t miss you at all. Why should I? You give me nothing of value anyway. I haven’t heard that response this time around, not yet, but there are still two more days to go in this first week back.
Which brings me to the client I discussed in my last post — the one who abruptly terminated. One detail I neglected to mention was that these interactions took place on the cusp of my vacation. In one of our exchanges, when I had pointed out to her that she was mis-using my special cancellation policy to avoid becoming dependent upon me, she replied that I was the one who had cancelled twice in a row (meaning the two sessions we’d be missing over my break). Although I didn’t say so, I wondered at the time if, in addition to her other reasons for quitting, there was a kind of tit-for-tat going on. After a lifetime of serial abandonment, she would naturally experience my impending vacation as but another instance of an unreliable caretaker letting her down; she was then “showing me” what that felt like by “abandoning me” in return.
I never got the chance to make that interpretation and find out whether it might be true. Over the years, I’ve had other clients who quit just before or after my vacations and never came back. For some people, if it comes too early in treatment, the experience of “abandonment” — of being left with needs that go unfulfilled for any length of time — is unbearable. For others, it’s an emotional challenge that often sheds light on their emotional issues, especially their feelings about what it means to be emotionally dependent on other people — people who will inevitably frustrate, disappoint and let you down.
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My therapist is going on vacation in a couple of weeks. I hate that he is leaving. I hate it more that I care. We have tried to talk about his leaving, I guess I should say that we have talked about his vacation. I hate even talking about his vacation. I refused to say much. I couldnt make myself talk. Also he mentioned his vacation about four weeks before his departure (he will only be away for a week) I have actually believe that he was leaving each week as the weeks go by. It’s funny. I know that I am improving because I am aware and anticipating his vacation instead of ignoring and avoiding the worry. In the past I said fine, what’s to talk about, you’ll be gone, I’ll be fine end of story, let’s move on. Now I’m still not ready to openly admit to needing or missing him. (I actually find this difficult to write.) I am, however, able to anticipate at least some the void that I will feel and the need that I loath.
Ahbhh, progress step by tiny little step.
Yes, but it sure does sound like progress. Denial at first, then gradual acceptance. Eventually (maybe a long time from now) the breaks won’t matter so much.
I hope so. I believe so. Maybe, I simply hope so.
So interetsing to hear about this side of the therapist – client relationship. I had never really considered how vacations are handled.
Hi Joseph
Thankyou for sharing your experiences around breaks in therapy.
Your post starts with the concept of dependency. I find the whole concept of dependency (rather than dependable) bizarre. I do not understand how dependency can be a healthy form of attachment or a healthy way of living as an adult.
Perhaps I have misunderstood your point but it has been my experience that there can be a slightly narcissistic overtone to this in some therapists. I can however relate to the way in which holidays can bring up feelings around abandonment, dependability, and even the value of that relationship.
Thankyou for allowing me to share my views and reflect on others experiences
I think the problem is with the word and how our culture thinks about it: dependency = unhealthy dependency. To me, dependency is a fact of life in human relationships. For example, I depend upon my clients to provide me with an income. We are mutually dependent, though our needs are very different. You can’t use the words “emotionally dependent” without it sounding somehow like a bad thing, but I’m emotionally dependent on all the people I love and care about. I need them.
That kind of dependency is different from, say, helplessness … or the inability to function without another person. Utter dependency. Sometimes clients who come from traumatic backgrounds have to become highly dependent in that way, but it’s not supposed to be forever. The idea behind dependency is that you need something, and that you get what you need in the context of a relationship. Sometimes, it’s ongoing — as in a marriage, for example. Usually, it’s meant to be time-limited: infants and small children are highly dependent but they hopefully get what they need from their parents and grow up. Clients in therapy get what they need from their therapy and then go on to use it independently.
I hope this helps clarify what I meant. And I know what you mean about the narcissistic therapist.
Hi Joseph
Thankyou for your comprehensive explanation and modelling what a healthy dependency is like. In reading your reply I was reacting to both the word itself and a few encounters with narcissistic therapists. It has been my experience also that this can also be a gender laden issue. Thankyou I look forward to many years of emotional dependency!
Welcome back, Dr. Burgo,
After reading this essay, I am left wondering what healthy emotional dependence looks like? How would you describe it? Does it even exist?
Or, is the psychological task to learn to become emotionally self-sufficient and compassionately detached from others, even in the context of marriage or other kinds of intimate partnerships?If so, how? What does one need to understand in order to accomplish this endeavor?
My question stems from my growing awareness (and dismay) that my attachment to my husband is excessive and unhealthy. It leaves me feeling bereft as I contemplate his advancing age (70), declining health (4 major surgeries in the past year), and his demanding career which involves frequent travel. He seems unable to slow down and savor life. There are times at which I fear for my ability to function in the event of his passing. And I experience deep resentment over feeling neglected by his all-consuming work.
I sense that my psychological task is to increase my internalized sense of competence, self-sufficency, and safety, but I am not sure where to begin.
Thank you.
Hi Angela, I’m not sure what you mean by “excessive and unhealthy” dependency on your husband. Maybe that’s accurate, or maybe it’s an inevitable fact that we’re all dependent upon the person we marry. My reply to the comment before this one might help clear it up a little. I don’t think that “detachment” is necessarily the goal, although I certainly understand your feelings of resentment. You need something from him that you’re not getting so of course you feel frustrated and angry. In addition to developing a greater sense of competence and self-sufficiency, you may need to develop other resources, turn to other relationships to get some of what you need (I don’t mean affairs).
Hi Paula, I don’t work with insurance any more, partly for the reasons you mentioned — that the insurance company decides what my fee will be. Also, as time went on, the reporting requirements/paperwork became way too onerous — you’re really working for even less because of all the un-reimbursed time you have to spend in order to be paid for the actual time you worked with the client. I decided to charge less but not accept insurance and most of the therapists I know have either done the same thing or are moving in that direction.
I’ve been with my therapist for 8yrs now, and its been very hard learning to deal with the breaks. She always senses a card to me now during her breaks, that was a way I could still ‘hold’ onto the relationship. To me it always felt that if she was gone, then what we had went with it. Only now am I begining to hold onto the relationship and think about it in useful ways during breaks. There is now room for me to include lookiing forward to seeing her again, that was impossibe in the early yrs, to much pain.
It sounds like you and your therapist have done some really good work together and made serious progress. It takes an awfully long time to develop the ability to “hold onto” the relationship during a long absence.
An insightful post, my own therapist often questions how I am going to feel if he is due to have a break and I reply fine, which I am because I prepared myself, however if he lets me down and is off sick (which has happened recently) I get annoyed, but mostly with myself for not accepting therapists get sick. I attended group therapy today and decided it was time to bring in an important issue that was raised in my individual session earlier in the week. However my therapist was not there, apparently something had happened at home and he was unable to make it to work… it floored me and I struggled to hide my feelings and emotions from others in the group.
Now I find myself saying, I am having two weeks off, I am not returning which means given the planned Easter break I shall be four weeks free of therapy, I tell myself I am doing it for me to have a much needed break but I question am I doing it to get back at him…
Keep asking yourself that question. It sounds to me as if it might be a kind of tit-for-tat response.
Tell me about it! I was so hurt and angry (yeah I know it’s all about my deprived childhood) when my therapist left on a two week vacation without talking about it with me. Yes, I could have brought it up but he’s the one who has to prove he cares, though he doesn’t seem to realize it.
So he says nothing but “bye” and I’m left to try to hold onto a shredded thread of a connection- and he’s not even holding the other end! He’s surfing the waves in Peru or something, and I’m sitting in an unmade bed holding a thread.
He didn’t even think to ask if I wanted to move my session from Friday to the beginning of the week, because with a Friday session, it was really three weeks before he reappeared.
By the time he got back I had dropped the thread. I was hurt and furious. He didn’t even inquire about how the absence affected me, I had to bring it up.
He said, “Yeah, I regret not checking in with you about that.”
Really? Do you?
I don’t even know if our relationship recovered.
Being needy sucks.
As always,Joseph, reading your articles with interest, and always learning something!
Maybe I am missing something here, but does it not cross people’s minds that the therapist (like everyone else) needs his or her holidays! That it is NORMAL for people to take holidays!
I agree, Joseph, that dependency is a fact of life. But malignant dependency is another matter entirely. As in, living for the “other” to exclusion of all else. As you put it:
“…. or the inability to function without another person.” An idea to make the blood run cold!
I suppose the right idea is “inter-dependence”. In a marriage/ partnership each being his/her own person, with separate interests, friends, while at the same time enjoying mutual interests and friends. Couples I know who have been happily married going on 40 or 45 years I have noticed that is how it is with them. They don’t live in each other’s pocket.
IMO love is not about need, but about letting the “other” go (gosh, not sure if I am putting this at all well!).
Best to everyone
Hermes
I’m experiencing alot of transferrence with my psychologist. It’s actually kind of taken me out of my mind. I started feeling like I was in middle school again. Like he hated me because I was ugly and I was struggling…. One time he was saying something and I told him to shut the fuck up. I felt so bad… I said, you know I didn’t say that to you I said it to myself… And he was like what do you mean, and I said to me? Why did I say that? I don’t know why I said that and I’m too afraid to ask him.
You should definitely take it up with him. I wonder if the hatred stems from this feeling you have of being “ugly”, like he’s the beautiful, healthy one and you’re the ugly, struggling one. I have experienced that dynamic before with different clients.
Dear Joseph,
Thank you for another wonderful insightful post.
I am having a lot of problems with my therapy due to just this problem. Due to work commitments and my therapist’s leave (usually only 2 blocks of 2 weeks per year), I have been unable to see my therapist for about half of 2011. I have blocks of 3-7 weeks when he cannot see me. After such a break, I feel emotionally flat and angry and have great difficulty opening up to him again. I’ve just had a block of about 8 weeks after a break of 7 weeks and I felt I was only just getting back to where we were before. Later in the year he is having 6 weeks off for an extra holiday, as weel as his usual holidays. I already feel angry with him for this. He says my reaction to these prolonged breaks is due to my insecure attachment, and as you say above, it highlights the fact that people will frustrate, disappoint and let you down, but surely this could be damaging to the client and counter-therapeutic?
Louise
I think it would all depend upon how the therapist handles it — that is, if he or she validates and accepts the feelings. It does sound, though, as if you’re having an amount of separation that feels intolerable, and that could ultimately be counter-therapeutic. I don’t think the answer is for him to take less vacation, though. In Europe, it’s routine for analysts to take 6 weeks off every summer.
Update to my March 15th post.
It did recover.
What a difference one session can make.
Why would a client bother trying to get back at a therapist? The therapist does not care whether the client comes or not. If one client does not come, the therapist will find another. I cnance the appointment sometimes for various reasons. I have never known the therapist to care. I do give several day’s notice. I don’t particularly care if the therapist takes a vacation. I can fill my time without them. And save a great deal of money.
The way a therapist may actually feel, and how the client imagines that therapist to feel are two entirely different things. Over the years, I’ve had any number of clients who tried to retaliate for what felt to them like abandonment.
You are right, Joseph. Therapists/psychologists/analysts over here do take their holidays. A “long” month would certainly be usual, although in some cases professionals (of all kinds) prefer to break their holidays into segments. So, yes, six weeks, for sure. It seems only fair, as therapists must need considerable rest to re-charge their batteries from what must be a very demanding profession.
Best wishes
Hermes
My therapist just told me today that he is going overseas next week to visit friends. I do not know when he is leaving and I do not know when he is coming back. He was extremely vague. He just went away on vacation for 2 weeks last month, so I was really surprised. I feel like he has nurtured my dependence upon him and leaving again is bringing up all kinds of feelings of abandonment. I feel like an idiot. Why should I care if he has a nice holiday for himself? I sincerely hope that he has one. The problem is that I feel, and my inner child feels, devastated…again. And I do not know what to do to cope.
In my opinion, your therapist is behaving in an unprofessional way, and one that could easily have a very traumatic effect on his clients. Vacations are inevitable and necessary; but he needs to be reliable, consistent and predictable — just like a good parent. He needs to give plenty of notice and specific an exact date for his return. Imagine how a baby would feel if Mommy up and left and you never had any idea when (or if) she was coming back? What allows growth to occur over time is the development of a sense of trust that Mommy (and your therapist) always comes back.
I’ve discovered a strange thing after my therapist took a vacation. Before she left, we were touching on some pretty sensitive material, i felt very attached to her and felt i really needed her. Mentally i wasn’t doing well, these issues we discussed prior to her vacation were excruciating. I wasn’t too bothered about her vaction although i found it a little difficult knowing she wasn’t available to me.On her return, we’ve had two superficial meetings but i put that down to perhaps just reconnecting, but i have magically no feelings at all about this sensitive things i was working thru before the break. I barely even have memory of what it was that was even bothering to such a extreme. My clinical depression has miraculously disappeared and i no longer feel like i need therapy. Am i “cured”?
I would say that you’ve detached from her, cut her off as a defensive response to feeling “abandoned” by her, despite what you know to be the reality. The words “magically” and “miraculously” suggest to me that it’s a kind of manic reaction; in time, the “magic” will fade.
I came upon this post i think at the right time. vacations for therapists have depended on the therapist i was seeing as to how i would react to there going away for awhile. one therapist i was extremely attached to would take a complete month off every summer. she would arrange for another therapist to see me. one time she made a tape of stories she read so that i could feel connected to her. nevertheless i would feel extreme pain in her absence. one of those summers a person we both knew & loved died suddenly. I went to the memorial service but a few days before the service someone called me to advise me to leave my therapist alone before & after the service. That is what i did. she spoke at the service. I could feel her pain & i felt mine. i wanted to hug her after the service but i heeded the warning. after she returned from her summer vacation i told her about this person who had called & what they had said. she said that it would have been okay for me to come over to her for a hug. she was surprised i didn’t. that was a while ago & because of insurance i lost that therapist. where i am now is why i am writing this response to your post. vacations for therapist can be quite difficult on their clients. (by the way a great post.) but in most cases the therapist prepares their clients for that separation. what doesn’t get prepared for is when a therapist is out sick. when it is one day here & there throughout the year, that is something one can adjust to but over the past month- 3 weeks, i see my therapist twice a week, my therapist has missed 4 appointments out of 6 scheduled. i have seen her only twice in April. I go twice a week because i need to see a therapist twice a week. I have also been going through some very intense emotional times & have been in some serious trouble trying to keep myself from losing it & doing something extreme on multiple occasions. i tell myself it can wait. i’ll be able to make it until tomorrow because i will see my therapist then. but in the morning my partner wakes me up to tell me your therapist is out sick again. she is sick actually quite often & has cancelled many times since we have been seeing each other. i do not know how to deal with this. i am feeling very angry inside & last night i really lost it & freaked out but then i thought i would see my therapist today but once again another call saying she was sick. is it unfair of me to want to ask her to arrange for me to have a backup therapist that i can work with if this is going to keep on happening? talk about separation & dependency. i just feel like we are making progress & recently i had some breakthroughs about what is going on inside me & i really thought we would have been talking about these things over the past weeks. but the insights are slipping away. what would you do if this were happening to you & for whatever reason you had to cancel on an all too regular basis. i need my therapy & i am not getting it. i enjoy my therapist but her absence is affecting my relationship with my partner & emotionally i feel like i am having a hard time keeping it together.
I have a hard time understanding so many cancellations. Does she have a chronic and severe illness, or are we talking about cancelling because of a cold or the flu? As a basis for comparison, during my 30+ years of practice, I had to miss one entire week during my early 20s when I came down with the mumps; other than that, I have cancelled exactly once because of illness. I had a fever so high I literally couldn’t think. In all other cases, I work even if I’m sick because I know my clients depend on me to be there. Unless there’s some very good explanation for these cancellations, I think you need to find a different therapist. She may be having a hard time handling the work emotionally, or going through her own personal difficulties, and is cancelling due to “illness” as a result.
That’s interesting. I do have abandonment issues/attachments issues. Could you elaborate on what you mean by a manic reaction? I do detach when i perceive abandonment, emotional or otherwise. However, why can’t i control this, i WANT to feel connected to her, i don’t feel like she abandoned me, she took a well-earned break, she is looking after herself so that she can look after her clients. I don’t feel anything bad about her vacation. Why is this detachment or “manic reaction” happening when it’s at odds with how i feel and think about the vacation and about my therapist?
When something happens all at once — that is, miraculously or magically — I think of that as a manic mechanism, although it sounds like using that term wasn’t very helpful to you. I don’t mean to say you are manic, or manic-depressive; only that there’s an unreal quality, a flight into a sort of fantasy about everything being suddenly different — that is “manic” to me.
Otherwise, what you are noting is the difference between the adult, rational side of you that understands perfectly well that vacations are necessary, and the not-so-rational “baby” side of you that feels abandoned.
That is so interesting, thank you for taking the time to explain. I’m fascinated by the human mind and i love how you explain things. Excellent blog Dr Burgo!
Thanks, Olivia!
I appreciate your post. I have been working with the same therapist now for over two years, and in my 13 years of therapy he has been the most helpful person I have ever worked with. Additionally, I have feelings of erotic transference toward him that have been present almost since the beginning. He knows of them and we’ve discussed them.
He will be leaving in two weeks for a three week vacation because his wife will be giving birth to their first child. Surprisingly, I have more feelings about his upcoming absence than I do about the baby. Perhaps because the former effects me to a greater degree.
I am really concerned that I’m going to fall apart while he’s gone. I know rationally that he is not leaving me or abandoning me, but I struggle with abandonment issues (especially beging diagnosed with borderline personality) and that’s sure what it feels like. I feel guilty about this, as though my difficulties would be deliberate and intentionally manipulative. When I know full well that he wouldn’t even find out I was struggling until after he came back and me having a difficult time isn’t going to make him come back earlier.
On top of this, I’m also filled with anxiety and fear over terminating with him in several months when I will be moving out of state.
That’s an awful lot to be dealing with. It sounds like you’re not remotely ready to be terminating with him; is there any chance you could continue to work with him from your new home state? I do the majority of my work by Skype now and find it’s a very effective medium. Given that you have already worked face-to-face, I think it would be an easy transition.
In my experience, the “erotic transference” is often a screen for the infantile transference. It feels so much better to be an adult person, having sexual feelings for another adult, rather than a baby whose mother has just left her. I also imagine you have more feelings about your therapist’s new baby than you’re aware of at this moment.
I don’t think that working with him over Skype would be feasible. He is employed by the local community mental health agency and they pretty much dictate his practice.
My immediate thought after reading your comment about having more feelings about the baby than I realize, was that I feel as though I’m being replaced. I have always wanted to make my therapist proud, very much in the same way that a child wishes to please their parent. And I’m very afraid that he’s not going to come back after his leave, even though he said he’s going to.
Compounding upon this stress, he canceled our appointment today only an hour and a half before the session, said something unexpected came up. I presume his wife went into labor. But it’s such a bad day for him to cancel on such short notice, as I spent 7 hours last night, well into this morning, at the ER after taking a large amount of Tylenol. I knew it wouldn’t stop him from going away and in some karmic way it seems to have led him to depart even earlier.
I am forever that baby whose mother just left her (having been abandoned and given up for adoption the day after I was born) and I take that with me into all of my relationships, not just with my therapist.
I wish this were easier.
Clearly you are deeply attached to him; you may need to make arrangements to work with someone else as you transition out of therapy. Don’t wait until you’re in another crisis state of mind.
can’t leave information but I must say this revelation has given me hope to outgrow my
disorders and ease off of my therapy eventually-
signed just in time soon , just in time smart-taken and rearranged from Dr.
Gordon Livingstons books .
thank you Joseph Burgo,PhD
What a fascinating piece. Personally, I’ve been in one sort of therapy of another for 20 years, it isn’t that I have so many problems, we just didn’t have the right diagnoses for like 15 years. I’m not bitter over it, it was CBT, and who couldn’t use a good dose of CBT, right? But, I disgress; I’ve never felt this way about my therapist vacationing. Good Lord, spending an hour a week with me has to be exhausting (Adult ADHD and all the “accessories”). I’m happy for her to go on vacation, I wish her well, and tell her me and my “accessories” will see her again in a few weeks.
I simply never realized a vacationing therapist caused anyone pain, this could be a good place for me to try to be more supportive of my friends that are in therapy as well. A couple of us visit the same therapist, and I certainly can’t do as much as our therapist does, I can still listen to their feelings. Thank you for the insight, it gives me a good place to be a better friend.
I think this is really interesting and a relief to read!!!. I have been in therapy 4 1/2 years with my th to erapist going away on averae every month. she takes 6 to 7 weeks in the summer, two weeks at christmas, three weeks in february and many more single weeks throughout the year as she runs groups around the country. I find it hard enough to keep up with the comings and goings, but also the stopping and starting which for me seems never ending. For me it makes it impossible to maintain stability. I have to say that the thought of being dependent on my therapist scares the life oout of me and I fight it tooth and nail. I have discussed this with her several times and have concluded that for someone with attachment , neglect and abuse issues it would be more benifical to attend a therapist who does not take so many breaks.
Thank you so much for sharing your views, its so reassuring to acknowledge the impact from the clients point of view and question if my therapists should be acknowledging that she can not offer what I actually need rather than trying to find ways of “filling the gap”
I can’t imagine entrusting myself to the care of someone who was so unreliable (in the sense that she was always coming and going). If you have attachment and neglect issues, I think you may very well be better off with someone able to offer you a more consistent schedule.
Thank you for this article! Very interesting. I ran across if after googling about therapists and vacations, trying to understand my own feelings and experience this week. I have been seeing the same therapist for about a year, but also seen her sporadically (a year here or there) since 2001. In the past year, we have begun doing trauma work related to severe emotional neglect that I had always resisted looking at in therapy before. Two sessions ago, I felt sort of misunderstood and unheard by her. I shared these feelings last session, kindly, and she apologized, saying her own transference must have gotten involved. We talked about the therapy process itself and how we could better work together. It felt good. We then spent the session rebuilding the trust.. I felt heard, it was good. As we go to confirm next weeks appointment time at the very end, she tells me she’ll be on vacation next week. It was preplanned, but she forgot to tell me. Shes done this before and I’ve told her that some warning (even at the beginning of the session prior) is SO important to me… I hate being surprised with it. But I got surprised again. She apologized briefly and asked how it felt, but there was no time to discuss it. It’s only one week, so not that long… but it has shaken me very badly. I feel angry and hurt and I’m ready to walk away and not return. Not just because of this, but other things that she has done that make me feel unsafe also in the past 6 months.. and this is just the icing on the cake. Am I crazy and reacting totally out of past abandonment issues? I’m certain my own sensitivities play a part… but it feels wrong for her not to give me any warning, especially given the work we’re doing and the current trust issues from the week prior. Do therapists owe us some kind of advanced notice?
I think some advance notice is definitely needed. On occasion, unplanned absences will occur but usually several weeks notice (or more) would be given. I’m not sure what this has tapped into you — it would be worth looking at — but there’s a legitimate reason why you’re upset. Hearing that she “forgot” to tell you only makes it worse because it feels like she has “dropped” you just when you’re most sensitive. This isn’t necessarily a make-or-break issue, but you should certainly bring it up in your next session.
Hi Amanda,
We have similar experiences. In the four years I’ve seen my therapist, he has made efforts to give me proper notice of long breaks as well as the occasional session or two that he can’t make. Most of the time, there’s no problem.
However, he has also forgotten to tell me about breaks several times, and it’s very upsetting. I expressed how upsetting this was one time and he did apologize, but on other occasions he won’t say anything or will try to connect my feeling with something from the past, which may be important, but in the moment feels pretty lousy. I wish he’d say something like, “man, it must’ve really pissed you off when I made that mistake with the break.”
And then this other thing that’s almost worse than forgetting has happened many times: for example, he might say on a Monday, “I will be away Friday of next week.”
I’ll say “OK” and jot it down on my phone calendar. Then, on Friday of the same week he’ll say, “just a reminder that I’ll be away next Friday and the following Monday.”
I’ll say, “uh, wait a sec. I thought it was just Friday?” His response might be “oh yes, just Friday” or it might be “no, Friday and Monday” and I’ll be left just feeling kind of stunned.
We’re on a two-week break right now, and before the break it happened again. He won’t be back in town until next Tuesday – which isn’t a normal meeting day for us, but he was good enough to offer that as a time to meet since we won’t be meeting on July 4th.
Again, I put it down on my phone: July 2. Then on the Friday before the break, he said, “we’ll plan to meet on the Friday after the 4th of July. Again I had to remind him that we agreed on Tuesday, July 2. He said, “oh yes, that’s right.”
So, like you, I feel angry and hurt and ready to walk away, for this and other reasons. I don’t know what I’ll do, but first I will talk with him about it on Tuesday.
I hope things work out for both of us.
Thank yo for the awesome read! This is actually the other way around for me. I’m taking a vacation, and I’m trying to decide if I should continue therapy or not. Obviously, this is a decision only I can make, but it’s pretty tough. One of the factors is that I had a session scheduled right before I was going away, and my therapist missed the session. I do therapy over the phone with him, and he didn’t pick up. I called continuously, left 2 messages, etc. I feel very abandoned and unstable now. He’s supposed to be there for me, and this is the second time it happened. He says I need therapy over the summer, even if it’s not with him. I am in contact with another therapist, so I’ve kind of been doing 2 therapies at once. I’m just wondering if I should quit the first one altogether, or should I try to make some headway with it in therapy?Thank you!
It sounds confusing. The fact that he’s unreliable only makes it harder for you to bear needing help. What about this second therapist? Is this someone you can trust and have you already engaged in therapy? You only said you’d been “in contact.” I don’t think dual therapists is a good idea, and if you trust this second one to be more reliable, you might want to make a transition.
This is an excellent blog post, thank you. I started counseling about eight weeks ago. My counselor communicated his recent vacation plans as a “last minute bomb” at the end of a session; after reading this blog and thinking about it I am realizing that we do indeed have a “last minute bomber” in our relationship (on several other important issues as well), and it’s not me — it’s him! He’s an intern so this will definitely be useful information for him.
I will also say that, to his credit, his vacation (which indeed did feel like it came too early in my treatment and likewise at an inopportune time given the issues we were working on) was preceded by our coming in very early the day he left so I could have a session before he went. I very much appreciated that because it cut the separation time in about half. He offered it and it didn’t come loaded with any shame at all, so I appreciated that as a gift, and also a recognition that the separation was going to be challenging in and of itself.
My personal feeling about vacations is that we all need them, and I want to respect my counselor’s need for time away. It also got me thinking of how long it’s been (3 or 4 years) since I’ve been away anywhere for more than a day (I take care of my very ill mother). I’m now making plans to escape for a week myself. With my luck my mother will die on my very first day away. At this moment, I’m trying to convince myself that even if this happens, I will have done my best for her for many years. Once that convincing is done, I am going to buy a plane ticket and feel very good about paying my counselor for the session I am going to miss.
Thank you again for your excellent post.
Enjoy your long-overdue vacation! As for your therapist, it sometimes takes interns a while to learn the importance of giving sufficient notice and what vacation breaks mean to their clients.
We have two minds in the same place. I actually decided to have this discussion with him last week. I told him that while I was okay with his recent vacation, if we had been in one of the deeper places we are planning to go with my counseling, it might have felt a whole lot different to me to have him away and unavailable. And being able to talk about that in an unhurried way would have been very important. I think I got through to him. Maybe I saved him part of the travail of his learning curve on this topic. Thanks again. And p.s., I am going to enjoy that vacation.
Dr. Burgo:
I always enjoy reading your blog.
The therapist I have been seeing left for vacation this past Wednesday and he informed me during the appointment that at 6 p.m. he would be officially starting vacation. I texted him around 4:30 p.m. and he replied at 6 and then sent me another text at 6:01 p.m. that said, “I am now officially on vacation.”
To be honest, I was kind of taken aback by his text. I understood he was going on vacation and I understand he needs a vacation. I felt as if he was saying, “Don’t bother me while I am away.” I could be misconstruing it, however, I truly understand boundaries and would not bother him while he is on vacation. He needs one, and when one goes on vacation, they want to rest, not having people pull on them emotionally while they are trying to recharge and relax.
I honestly have been trying to not become attached and keep a good amount of distance in between us. I am comfortable with that. To say that his last text did not bother me would be untrue. I am an adult; I felt he automatically assumed that I would not honor his time away.
While he has been away, I have been thinking that maybe I don’t need therapy. It seems that it is becoming complicated due to trust and attachment issues.
I have not been in therapy that long but I am fighting the attachment to the therapist I have been seeing. I stated that I had no desire to become attached, that I would do the work, but I did not want to become attached in any way.
As you probably know, I believe that attachment is necessary for the important growth to occur. Given that you’re a relatively new client, the therapist may have handled this situation a little awkwardly; he may not have understood that you would respect his need for vacation and therefore was setting some firm boundaries.
The way in which you’re thinking that you don’t need therapy during his vacation isn’t unusual. But it’s a defense, a way of warding off the fear of becoming attached. Be brave and talk to him about it when he’s back.
Hello
I have been seeing my T for about 1 week for about 4 months and I have never been able to be like this just somewhat grounded and feeling save, so now he is on 8 weeks summer vacation it common here 4-6 weeks in summer time, and he wants NO contact in this time, but now I am feeling little bit lost and really need some advice on some topic, but my T knows my problems and what I need so I can be ok, so I am little bit struggling now, should I contact him or let him be, I wish I could trust someone else, but it has taken me 2 years to trust him, and sometimes I think its unfair he can just say see you in 8 weeks , but somehow my life is on hold. Am I making my life to hard ??
I do understand that my T needs time to recharge and time with his family, I am also afraid he will just be so happy to get rid of me , or forgets me , and I am left alone , after all the work it took to trust him..
I feel like I am forcing my T to have me in therapy, and shortly before his holiday we were talking about some heavy stuff, and in the end of that session he said well I see you in 8 weeks and I just what, don’t we have 1 time before, so I could prepare myself and have some resources like coping list , I had to come up with all that and more, he did agree to see me 1 more time before holiday, I did tell him if I were a normal patient I would ask for some name but I can’t make a another contact it’s just too hard for me, but he did really not give me any advice to cope in this 8 weeks…
I am so lost, do you have any advice ?
When a therapist takes such a long vacation, it’s typical to have someone on call. I understand what you say about not feeling able to contact another therapist, but it sounds as if you really need to do that. Eight weeks is an awfully long time when you’re so attached. I’ll bet that his voice mail or answering service message has the name of someone on call — why not give that person a try?
I used to dislike when my counselor (non credited counselor) used to take vacations. She often traveled so you’d make an appointment only for her to cancel and say she was going away and leaving that day etc.
It took some time to get used to her traveling and canceling or rescheduling. She had no backups so early on when in crisis it was extremely difficult.
That must’ve been rough. I think consistency is very important for developing a sense of security in the therapeutic relationship, and sudden cancellations can undo months of trust-building.
Dear Dr. Burgo,
I have been seeing a psychodynamic psychotherapist for a little over a year. I have zero attachment to him and am not in any way dependent on the therapy – in fact, I’m relieved he’s on vacation right now (for 3 weeks) and am enjoying the break. Can the treatment be effective when I experience zero attachment and virtually no transference at all?
Thanks,
Laurence (female, 32 years old)
I’m not sure how to answer that question. My first response is to wonder about your defenses against the awareness of dependency, and whether you’re a hyper-independent person whose character is marked by self-reliance. That defense can be so effective you might have no awareness whatsoever of your (unconscious) need for or dependency upon your therapist. Being relieved that he’s on vacation might in itself be a defense, a kind of reaction formation. Does your therapist take up your relationship in this way?
Dear Dr. Burgo,
Many thanks for taking the time to respond; I really appreciate it. I think part of the problem is indeed that I am quite independent and value self-reliance and autonomy more than just about anything. I’m also wary of the *assumption* of dependency in this type of therapy, and have barely been able to “bond” with my therapist.
In addition, I find the notion of attachment in therapy odd; I have lived most of my life without a therapist and never feel the need to call him or share anything with him outside sessions, the way I understand some clients do.
I recently read the 1970s pulp novel “August” by Judith Rossner, which is about a New York psychoanalyst and her teenage female patient and, specifically, the hard time patients have when their analysts go away for the summer. I wasn’t able to identify at all. I’ll try to bring all of this up with my therapist when he returns from his vacation.
Thanks again,
Laurence
I am so glad that I found this web page. My therapist is on vacation as of today and I am feeling sad. It was so helpful to read that this is a normal reaction. I have been seeming my therapist for a\two and a half years and he has taken vacations before but this is the first time I have ever felt like this. I have never felt connected to anyone before so missing someone seems so strange and wrong. Can’t wait till we meet again and talk about this experience. It does seem like a strange concept that I feel so connected to someone that I pay to meet with.
I understand, but just because there’s payment involved doesn’t mean there are no feelings on either side. You’ve probably told him things and made yourself vulnerable to him in ways you’ve never done with anyone else.
My therapist has had 8 weeks away between February and now and doesn’t seem to understand that I as a client might find that difficult. She has a good reason, she has cancer and is about to start treatment and so has taken time for surgery time for holidays time for recovery. The scary thing for me is that she says she isn’t sick. She has to have four months of chemo and then some more radiation treatment. Well people don’t need that kind of treatment. I know I am becoming dependent on her and that is part of my healing but what I don’t get is why she doesn’t understand my anxiousness around so many breaks.
It sounds like your therapist is in denial about her illness, and about the effects it is having on her clients. She may simply find it too painful and/or frightening to bear.
this is fascinating….and very helpful….I have been shocked by the plunge into despair I have experienced since my therapist went away. I am in the process of getting other kinds of support. So while I still feel hurt, angry, betrayed and abandoned….the adult in me says she simply needs a break and I need to find whatever it will take to keep wanting to live and find someone who will hear my pain!
It’s that divergence between the adult side of you who obviously understands your therapist’s need for a break, and the “baby” part of you that feels abandoned and angry about it, whatever the “reality” might be.
I found myself coming back to this blog today, remembering that it gave me a sense of comfort before, that you had given so much thought to how clients perceive absences. It’s also comforting to remember that I’m not the only one who suffers with the absence of my counselor.
My mother died recently, and I find myself on an emotional precipice looking into a deep black hole of grief that has to do with severe emotional neglect and abuse. I need to grieve the mother I never had, not the sympathy-card mother who keeps turning up in my mailbox since her death. Those inappropriate sympathy cards (coming from people who are very well-intentioned but haven’t a clue) upset me, and remind me just how much intimacy I lack in my personal life, that so few people had a clue what my mother’s and my relationship really was.
In the meantime, my counselor is gone for a couple of weeks. It feels like forever this time. It is two weeks. I knew about it well in advance this time (improvement), but the combination of grief, the trauma work we have just started, and some really bad and hopeless medical news I received the day after he left has put me in despair.
You probably recall my counselor is an intern; I could call his supervisor (who is his backup for emergencies) but I got a strong feeling in the last conversation we had before my counselor left that he really did not want me calling his supervisor. The two of them have different theoretical and therapeutic orientations, for starters. The other thing is that my current despair isn’t a life-threatening emergency. I am realizing now that we planned well for emergencies (I insisted on that) but not for real needs that fall something short of that.
I am back to the feeling I had when I started this counseling several months ago: that I am essentially alone in a very bad situation. My physical health and the myriad of challenges that accompany it is a very bad situation. My grief is a very bad situation. My trauma history is a very bad situation. And I am essentially alone.
I am wondering what is a normal-looking backup plan for clients who might be a little too fragile at any particular moment to tolerate a planned separation. I feel my counselor and I both dropped the ball on this. And, I was in better emotional shape before I got the recent bad news about my medical condition. I wasn’t anticipating that.
Thank you in advance for your kindness. I’m probably being a little too careful in this situation, thinking too much about what a proper strategy should be and being a little too considerate of what I perceive to be my counselor’s feelings about my calling his supervisor. Part of me says, “just make the call”, and deal with the fallout with my counselor when he returns. I really don’t know what to do. I also don’t want the supervisor to think I am dangling off a bridge when I’m not. At the same time, I feel I should not be alone with the despair I am feeling, if there is an alternative. What do you think?
Most therapists usually have a person on call to cover their clients during a vacation break. I have occasionally seen the clients of my colleagues when they’ve been on vacation. You do your best, but you can’t step into a relationship of long standing and make up for the absence of someone who truly knows the client. Your therapist may be in a tough position if he doesn’t truly respect his supervisor but has to leave him on call during the vacation. Maybe you could ask if there’s another intern he respects that you might see if you find yourself in need but not truly in crisis.
Thanks for this thoughtful post. It’s reassuring to see other people suffer similar struggles that I do.
My therapist is a very experienced psychoanalyst with 30 years practice. I’ve been seeing her for about a year. She has always been clear and upfront with me about her vacations, consistently taking them the month of February and August and talking to me many weeks in advance about the upcoming break, for which I am very grateful given some of the other posts I see here. She also has a backup plan in place for me when we do break.
As is more typical with psychoanalysis, I see her 5 times a week, so during this past year, I feel that even though I have deep trust issues that we’ve made great progress in me feeling safe and secure with her in so far as my capability allows. Even with all that, the two breaks we’ve had since I started seeing her were very devastating. During the first break, I actually saw her backup several times because I felt so lost. As a side note, I can tell others here that the backup is just that – a backup. I think I mostly felt like it was an affirmation that my therapist had been thinking about taking care of me more than getting any direct comfort in seeing the backup. Not to say it didn’t help at all, but it’s definitely not the same as feeling the support of your primary therapist.
During this past break in August, my dad had a brush with death. Given the deep difficulty of my relationship with him, our inability to connect in a way that I can tolerate and my need to still try to reconcile, I was an absolute mess. I emailed my therapist and she graciously offered to talk to me via phone a couple of times. She in no way made me feel anything but comforted and supported, but I did feel a little guilty encroaching on her down time. Despite that, it really did help me a lot to feel that support at such an unstable time.
Now that we’re meeting regularly again and talking about some of the fallout of my emergency trip to see my dad and all the emotional churn of this past month, I find myself deeply reluctant to rely on her again and I don’t understand why. It’s as if I can no longer believe that I can ever trust her like I did before the break again. After the last break this wasn’t an issue even though I feared it might be. Is this a passing thing? Should I be concerned that we’ve met two weeks now and I still withdraw from opening up with her? I try to talk to her about it and I make a little headway but even telling her this meets with resistance on my part. She has done absolutely nothing wrong, but I keep feeling alone and keep feeling like I can’t reconnect.
Thanks in advance for your thoughts.
It sounds as if the experience of needing her help and support so much during the break made you feel unbearably dependent on her, and a part of you now wants to withdraw from contact as a defense against that need. This doesn’t strike me as unusual or worrisome; I’m sure it will pass with time.
Thanks Dr. Burgo, it’s reassuring to know it’s likely temporary.
I understand that therapists are people, too, and need to take vacations, but what I’ve run into is therapists who seem to take sudden vacations or would not tell me they are taking a vacation until literally a day or two before they were leaving for a while. THAT I don’t find to be all right. I need time to adjust to the time I won’t be able to see the therapist, and if the therapist knows in advance he or she is flying to NYC, then why not tell me? Also, many therapists don’t put together a plan to help me if I run into an emergency or establish a back-up person to act as my therapist should I need someone to talk to during the vacation. The worst encounter I had with a therapist taking a vacation was when I started seeing someone when I was in crisis and after a couple of sessions, he told me he was taking six weeks off to visit Spain and told me I ought to be happy for him and that we can email each other during his vacation so he can tell me about all that he is seeing and learning during his trip. Yeah, no thanks. I dropped him.
Good thing you did. I agree with your views: advance notice and back-up support if the therapist can’t be available is important for trust in the relationship.
I was drawn to reading this not because it focused on vacations, but needs. When I started seeing my current therapist it was the first time I remember someone outright asking me what I needed. It was also the first time I’d ever really thought about it. In other words, I don’t KNOW what I need. I’m in a very scary, need but push away mode right now. I am aware that I obviously need many, many things or I wouldn’t be there. But in almost every session my therapist asks what I need, if I need anything, or checks in if my needs were met. I cannot answer. It’s extremely frustrating, even terrifying, to be so disconnected from myself that I can’t identify or put words to needs or emotions. Don’t get me wrong, I’m immensely grateful that someone finally does think about and ask what my needs are. But it’s gotten so I almost, at the very same time, resent the question because it so emphatically highlights my neediness! What do I need? I guess I need someone to tell me what I NEED. I go to an MD because I’m sick and I need them to tell me whats wrong with me and then judge a prognosis and the appropriate treatment (needs). Isn’t that why I go to a therapist? For them to educate me on what’s wrong with me and why, and tell me what I need in order for it to get better? Look, I have major trust issues, yes. But internally I want very much to trust this person and make my needs known. I just can’t. So how can things move forward? I guess I also should confess that to me, needs are bad. They have been in the past for various reasons. I fear depending TOO much, because I know myself. I know that I will keep people at arms length as long as my arms will last. But when they give out and there are no defenses left, I think I trust/depend too much. I can’t find the middle ground, not just for me, but in what a therapist would expect. I don’t want them to be bored, frustrated or discouraged because I don’t let them anywhere near, but I also don’t want them to be smothered, frightened, or feel like they have to push ME away because I’m too needy. Uuuggh! So can’t a therapist be frank and TELL you what you need? And can they not also perhaps, behave in a way that demonstrates to a client, what proximity is comfortable for THEM? I feel like switching chairs with my therapist for a session. How about I ask you what you need from me, and find out how you feel and what your expectations are? But I don’t want to infringe on any boundaries.
Ok I need to hush now. Sorry.
Don’t be sorry. I can’t understand why your therapist is asking you that question. Maybe he feels the need to be sure he’s addressing your needs, but it seems to me unreasonable to expect you to know what those needs are. I agree that it’s his job to try to understand what you need, and I imagine that would take some time. My advice is to be as candid with him as you can about how you feel.
I think he’s trying to get me to be mindful of my own feelings and needs, since I’ve always disconnected from them almost entirely. But then I’ve disconnected from most everything. I’m not at all good with talking, let alone candidness but yes, I think I will try to somehow turn it back around. I’m tired of having to answer that I have no idea. It just makes me even more frustrated with myself. At least now I know I’m not being unreasonable. Thank you.
I am very attached to my therapist and we have been working together for 6 years. This year as he was going on vacation my husband became ill and required emergency surgery. I felt abandoned by my therapist in this time of crisis. I had one session when he came back and then became ill myself requiring hospitalization for a week. When I finally went back after all these disruptions I had withdrawn to a protective place but didn’t notice it. I was protecting myself from feelings of abandonment. I was late for a session yesterday and then proceeded to tell my therapist that it didn’t seem to matter whether I came or not. Even I was surprised by what I said. He called me on it and the emotion poured out. I wish it could have been a two hour long session but here I am holding these confused feelings again about attachment that I thought I had managed already. I guess we have to learn how to hold them for a lifetime. And they become confused with feelings and longing for touch. I don’t mean an erotic transference; rather, a longing for a hug, an arm around a shoulder, a kiss on the head. A parental kind of love that I long for. I’ll just never get it and it feels so damn futile. Ugh.
I remember feeling that way about my therapist, too — just wanting a parental kind of affection. It’s very painful and frustrating. Maybe we just have to live with that unmet meet, but having genuinely affectionate relationships with other people, including our spouses, sure helps. I also found that being affectionate to my own children helped.
I am very attached to my therapist and we have been working together for 6 years. This year as he was going on vacation my husband became ill and required emergency surgery. I felt abandoned by my therapist in this time of crisis. I had one session when he came back and then became ill myself requiring hospitalization for a week. When I finally went back after all these disruptions I had withdrawn to a protective place but didn’t notice it. I was protecting myself from feelings of abandonment. I was late for a session yesterday and then proceeded to tell my therapist that it didn’t seem to matter whether I came or not. Even I was surprised by what I said. He called me on it and the emotion poured out. I wish it could have been a two hour long session but here I am holding these confused feelings again about attachment that I thought I had managed already. I guess we have to learn how to hold them for a lifetime. And they become confused with feelings and longing for touch. I don’t mean an erotic transference; rather, a longing for a hug, an arm around a shoulder, a kiss on the head. A parental kind of love that I long for. I’ll just never get it and it feels so damn futile. Ugh.
Hang in there. It does get better and it isn’t futile. It’s just hard.
Hi ,
I am so glad I found this site. I’ve had this therapist for about 7 years ( I see him for talk therapy) and I see other for EMDR work. My talk therapist doesn’t like when I cancel my appointments (sometimes I just have to cancel). He often takes a very long time before replying to my e-mails requesting an appointment after some cancellations. Since I travel for a whole month in the summer, he always cancel my regular appointments after I come back from vacation. ( so I seem to have a different problem here). He waits for me to go in for a regular appointment and then he announces that he no longer will have that time/day available in his office. He says that he’ll have time available at his other far away office. He’s done this (cancelling my appointments) twice. Both times happened after I’d come back from my four week vacation. I have talked to him about these cancellations and he was evasive about it and seemed to have been having fun at my expense! As long I am concerned, I still own him $25 in copayments and I’ll only pay him if he e-mail me.
I’m not sure what’s going on there. If you leave for a month and don’t pay for the sessions you miss, then he has every right to fill that time with another client who wants the hour, but he should inform you beforehand that this is the case. If you owe him money, you ought to pay, regardless of how you feel. He’s already rendered the service and deserves to be paid for it.
I first want to say that I’ve set a reminder on my calendar to make sure I buy your book on the 29th. I just recently began therapy and my therapist has gone out of his way to help me feel comfortable. It was difficult for me to follow through with going to the first therapy appointment and my therapist recognized this and spent about a month talking to me through email and as much as I told him that he didn’t have to keep emailing me and apologized, he continued responding and asking questions. I was able to open up and I repeatedly told him I understood if he wanted to bail on me. I finally understood that whatever I said would be okay and not cause him to think badly of me and abandon me. I even tried making him angry expecting a reaction that would be justified but hurt me so that I could tell myself no one will stick around.
Anyway I’ve been seeing him a little over a month and I am constantly mad at myself for being too needy. He often makes contact with me in between sessions because I send him an email where I’m upset. I feel like I shouldn’t bother him and he has never complained or made me feel like a bother. After each session I tell myself I will not contact him during the week and am afraid that he will get annoyed at me and want me to go away.
Tomorrow is my next session and I’m hoping that I won’t feel so silly for having needed to talk to him earlier in the week.
I imagine these feelings will go on for some time. They’re not unusual or “silly” but I understand your discomfort about being “too needy.”
I enjoyed reading this blog & everyone’s comments. I wasted 2yrs in therapy as a teenager. Then 12yrs later i tried therapy again & felt like she & the doctor were self rightous & treating me for the wrong stuff. I finally found a therapist who was awesome & i did some great work with her before i ended with her due to losing my job. That was 3yrs ago. Is it normal to need therapy again? Why didn’t feeling “cured” last?
Nothing wrong with needing therapy again. It could be that there are different issues that have started to arise since you finished your last stint. And there is no such thing as a “cure.” If you felt cured, it was probably some kind of denial.
Thank You J. Burgo for your reply. Admitting there might be something wrong that I could use some help with isn’t easy. Wish I didn’t feel like I failed on some level, it would make picking up the phone & scheduling an appt. easier.
I’m am comforted by this thread. Can you please help me. I have been in therapy with my psychotherapist for 2 years now. Recently he made a comment that upset me and I wrote a letter explaining how he had upset me and also included some journal entries which expressed my suicidal thoughts and self harm. My therapist has told me he won’t see me if I self harm which makes it difficult as I find it the only way to release extreme anxiety and lessens the suicidal urges. In the letter I told him to please let me know should he wish to make an another appointment and he has not contacted me in a month. I usually see him on a f/n basis. Is this me being dependent or what?? I feel abandoned. I needed him to contact me as I had expressed in the letter that I felt I was frustrating him and perhaps he doesn’t want to treat me.
Most therapists are afraid of clients who self-injure, partly because of the legal issues and their liability if a client were to die, and also because it just plan scares them. I’ve heard this story before, where a client is abandoned by a therapist because he or she can’t stop self-injuring. That’s hardly helpful and I’m really sorry.
Thank you for your comment. I guess I didn’t actually think about it in terms of the legal side and also that my therapist might be scared of it. That does provide a little more comfort, that maybe it’s not about me as an individual…. Thanks for caring enough to respond.
My first therapist told me she was pregnant when I’d been seeing her for about 5 months. She planned to take an extended maternity leave but was going to return to her practice after a few months. I didn’t really didn’t worry about her absence because all along I had figured I would be done with therapy by the time of her leave anyway due to financial issues. But in the next few months I changed my mind and decided I wanted to continue therapy with her after she returned. Only problem was – shortly after I made that decision, she learned that she would be unable to return to her practice (long story involving the clinic where she worked).
She referred me to someone else, and I’ve been with my current therapist for 7 months now. I feel like I’m just now getting around to significant things after over a year in therapy. Able to trust him enough to go places I couldn’t have before. I feel like something has “clicked” or I’ve relaxed or something and can get out of my head without becoming completely anxious about it. I just made the connection today of being in therapy with him just slightly longer than I was with my first therapist. She tried to get me to talk about how I felt about her pregnancy etc – and I tried. But I always felt like something was missing. Like she wanted something “more” from me, or out of our sessions, that I just couldn’t “get”. But now that I’m with someone else who seems like he will be around a long time, I think I feel safer to bring my feelings into our sessions. More able to stay with them.
My last session even felt significantly different because I shared in a more currently-vulnerable way than I ever have before (as opposed to just talking about things I’d already “worked through” or had thought about – as has been my usual style) I’m sure there are a number of factors going into this. But I really do wonder if crossing that 6-month mark of my first therapist’s pregnancy announcement was significant for me. I wonder if I couldn’t admit how much I would miss her and how dependent I’d grown on our relationship in a real feeling kind-of-a-way … and if that time period sort of played out for me again with my current therapist even without my realizing it.
Probably something to talk about my next session …?
It sounds to me like you have a pretty clear idea about what was going on. Your instincts are good: I think being “abandoned” by your last therapist affected you more powerfully than you realized at the time. I’m glad you worked through it enough to trust your new therapist.
Hi. This has been the most helpful sight I’ve found on the topic. Just ordered your book
My biggest question is what to DO to get through these horrible feelings during a separation. And I don’t even just mean for official vacations and illness, but just week to week. Trying desperately to break my urges and need to text or make contact somehow. He is so patient and kind but at some point he’s gonna hate me… He’s only human. But now that I understand the feelings better, and feel less crazy about them… What do people DO to get through?
Also, I now get that my suddenly feeling ok when appointment time comes, and inability to Feel when there are defenses. But how do I get past them? I long to just break Dow in the presence of a caring human being so I can feel those feelings not all alone just for once. It’s like a weird unique hellish type of loneliness I cannot break through.
One more (sorry)… What if it doesn’t get better? The dependency stuff? Is it bc I can’t make myself be truly present and show up in therapy To deal with it?
If your book addresses these things don’t worry about answering here
Thanks . For being there.
Anyone who buys my book will of course get an answer! And thanks you for supporting my site.
I felt very much the way you did in the early years of my therapy. Eventually, over time, I learned how to bear absence and not to defend against it with denial or destructiveness. I think it’s a question of weathering separations, over and over, so that eventually the experience of doing so helps you to feel less threatened and less dependent, more able to manage on your own.
I know it’s not a secret that clients miss their therapists. A question: do therapists miss their clients? Please, be honest as much you can. If they do, what reasons they might have?
Yes, but not at all in the same way that clients miss their therapists. I enjoy working with my clients even when it’s difficult. I think about them while I’m away and wonder how they’re doing. But I also think it’s important for therapists to get their minds off their work during vacations, to focus more on their own needs so that can re-charge and return with new emotional resources, ready to resume work.
You have to remember that the focus of the therapy is the client’s feelings and needs, not the therapist’s (at least not directly). Therapists are paid to devote themselves to understanding their clients and trying to give those clients what they need to grow. We derive gratification from our work, so we’re also getting fed, but in my view, it’s of a different order from what we give to our clients.
Thanks for your answer. I love reading your imput. I guess I miss my therapist. He’s canceled all my appointments because I’ve been away for so long during the summer. At least, it’s what I think. Nothing is clear…he hasn’t made it clear why my “old” schedule is not available anymore. I don’t think I should contact him because it feels like I am begging for help. I need to find another therapist and start fresh because the therapist/client relationship in this case is somewhat compromised. Don’t you think?
Since you miss him, I think it might be worth another session to get some clarity. Who knows what might come of it? If you don’t talk about it, you won’t ever know what happened.
This doesn’t exactly fit the topic, or not directly anyway, but I don’t know where to ask it. I don’t know what it means and it kinda scares me, and definitely makes me feel utterly alone… Though I experience chaotic and overwhelming emotions in normal life, and long to talk to my therapist in those moments, come appointment time I am just fine and not really in touch with my self. And I’ve never once been able to cry there. I know it’s safe. And he is safe. And this is frustrating as heck:-(
I wish I had something to tell you. It seems like this is very little to go on.
Something like what you are explaining happened to me for a while in therapy. I would look forward to the appointment, have interior dialogues with my therapist, & then get there and freeze. Part of i think what was happening was that i felt nervous once I actually had the opportunity to speak to me therapist face to face. I also found it difficult to decide what to talk about. I would frequently leave feeling like I forgot to tell her half the things that I wanted to tell her. This has grady gotten so much better. It happened so slowly that it is hard to say what caused the change. If I have to guess – I would say it was a combination of taking adderall, feeling a greater level of acceptance from
My therapist, and not worrying about what I ended up talking about. Also at one point she just asked why I thought I was having a tough time just talking in session. Somehow this made me realize that I could say whatever I want and that there was no real reason for my anxiety other than that it had become some kind of behavioral tic. I feel like it is so hard to figure about what about therapy actually helps. Sometimes it feels progress is made when my intentions (not the actual words stated or concepts discussed) and her intentions cross paths.
I have been seeing my therapist for five years. She usually takes one week off in the beginning of the summer, 2-3 weeks off in the fall. This year she is also taking 3 weeks off from November 20-dec 18th. I have have issues with change, sometimes the end of sessions, imagined abandonment, & separations. When she went away in June of this year she did not tell me in advance that she would be gone for 10 days. We usually meet 2x’s per week. A few months ago she did tell me that she was going away for 2-3 weeks in the end of November or begining of December. Today we met for our session & she told me we would not meet again until December 18th. I did not feel terribly upset at the time which for me, for those few moments, was very refreshing. As I was driving away I realized that I am going out of town right before she gets back. This means thar I won’t see her for 5 weeks. During our session today she also told me that within the next year she will no longer take insurance which means that I will have to go from 2 to 1 sessions per week by June. I feel like we have done good work together but also feel frustrated that she was not particularly considerate. I think it is the therapist’s job to give notice about vacations & reminders 1-2 weeks before the start date.
Regarding the insurance issue she is definitely giving me advanced warning. To add another layer to this there is also the possibility that we might be moving to another city. My hope is that she might do phone sessions but I have not asked her yet. Am I wrong in wondering why she is not being more thoughtful about these separations when I have told her that I feel very attached and that separations are very hard for me? I guess I am just confused. We also just finished moving awkwardly through some transference issues so I was just hoping for some smooth sailing. Am I reading into this too much?
No, you’re not wrong to feel sensitive about the lack of warning. You should definitely talk to her about it.
I’ve been in therapy for about a year, and get quite unsettled sessions are skipped because I rely on my therapist obviously but mostly because therapy is finite, and i fear there wont be enough time to deal with everything. I’ve had to take time off to travel for my work or vacation, and there were a few times she took a week off, but these were all planned events, and although hard, I could deal with it. The issue I have is all the last minute cancelled sessions. An emergency with another client, train to work delayed, illness. These missed appointments tend to happen in clusters, which makes it worse. Instead of the safe & reliable weekly therapy session, I get a feeling of anxiety before the appointments…. will she cancel again this week? She’s become flaky in my eyes. I also dislike the fact she never appologises/explains it. Is she waiting for me to bring it up? The only exception was my last session, which followed two cancelled sessions for illness. She appologised, and then said, she had to go on medical leave now for about 3 weeks, although she couldn’t be sure. She said she’d be in touch with the center’s receptionist when she knew her return date, and the agreement we made was that i’d contact the receptionist in week 3, to find out when she’d be back. I do this, and the receptionist informs me, it was always planned she’d be off for a minimum of 4 weeks. I don’t understand why she couldn’t say that from the start. We’re now at week 5, and she’s still not back. I appreciate she’s ill, and she needs to take the necessary time, but I hate the way its been handled. I have to check in every week to know when she is going to be back – why can’t she/the receptionist just email me when she knows when she’s getting back? To make matters worse, since our last session, i’ve found out that I have to relocate for my job in just over a month, which i’ve not even had the chance to tell her about because we’ve not had a session since I found out. So now ontop of the feelings of anger/frustration/disappointment and hurt associated with my unreliable therapist (not to mention the guilt that these feelings are unfair because she’s ill and can’t help it) , I have all the issues of a looming termination that I can’t even bring up with my therapist because she’s still off sick – the feelings of anxiety of loosing my support system and the person helping me to change the aspects of my life that aren’t work, the anger at myself of not being a better client so that I’d of made more progress on my issues which still remain so unresolved (not to mention the ones we never got to). Right now – I just don’t know if it was worth starting this journey.
Don’t feel guilty. Your therapist was flaky even before she got sick. I almost never cancel at the last minute — once or twice in my entire career. Plus she was dishonest about her planned leave for illness. My advice is to find a better, more reliable therapist.
My therapist has terminated therapy without warning me. He never said he was terminating but he hasn’t communicated with me for the last 4 months. He started distancing himself from me once I told him that I was interested in past-life therapy. Then one day I walked into his office to find out that our old schedule would no longer work. He said he’d be in touch and asked me to send him other times/days that I would be available. I felt hurt and not communicated with him for three months. Finally, I sent him the following e-mail and never heard of him again: “Hi,
I’ll be sending you one last standing co-payment of $25.00.
I’ve to say that it’s unfortunate that you’ve cancelled all my appointments
on two separate occasions without warning me or providing any explanation after the fact.
There are things that a therapist should make it clear to a client, if your intention was to force
termination, it would have been less painful if you’ve told me so. The relationship was strong
enough to end on a higher note. Unfortunately, you did not seem to get it or did not care enough to get it.
I’ll take the all the good things that those 7 years have given to me, regardless of how it ended”.
I am really pissed off at him and I want to have a chance to tell him but he’s cut off communication. I know I should look for another therapist but I am still angry at this one.
Do you have a suggestion?
Yes — as angry as you are, move on and find yourself a more tolerant therapist. The way he ended your treatment is unprofessional.
Thanks for your advice. I wish I’d find someone like you around here. Would you be willing to do a journal-type-therapy through IMS? I mean I’d write down my thoughts and feelings and you’d reply for 50 minutes. Please let me know what you think.
Sophia
Hi Sophia, I think emotional rapport is key for the work I do. I depend a lot on face-to-face visual contact and my intuition about other people that comes out of that experience, so I doubt I’d be effective in the type of therapy you’re describing.
Hi Joseph,
Thanks for your reply. I wish I could be your client but I can’t. I’ve read many of your posts and I find them extremely helpful. I do miss my therapist so much but I can’t contact him anymore. I do have to find someone as charismatic as you are, not all therapists are! I’m feeling stuck and unable to start the whole process of finding another talk therapist again. In a way I know that therapy should not last forever and I did tell him that I thought that 7 years was a long time. He did not agree with me. But then he basically terminated my therapy while in fact I should have been the one to make that decision. I know it is transference but it feels like a boyfriend breakup and I hate that feeling. Simply put, I really need to go back to therapy in order to explore this feeling of rejection. I want to forget him and connect with another therapist. This time around I will talk to the therapist about his termination policies.
Dear Joseph,
I just found your site tonight…. its incredible, YOU are incredible! Thank you for sharing your passion, compassion, commitment, intellect and HARD WORK here. It’s exceptionally kind and generous of you.
I have a chequered history of ‘therapies’ – some appalling, short ones (not therapy, in hindsight) and two reasonably good long term ones. Last May I entered a second analysis as I sensed that fundamentally I still had more issues than not…. I feel most fortunate with the analyst I have now. It feels like a REAL analysis/therapy AT LAST. Possibly a combination of finding a very experienced and able analyst and my own readiness for better level of engagement with the work. I have always tended towards positive transference with good or bad therapy. I have a very deep and often painful transference love/need of my current analyst.
He is warm, kind, caring – compassionate and passionate about his field of work also. He is generous with his time and very patient. He also, I think, works his patients hard – very hard. Despite my wanting to ‘get better’ (whatever that is), once the transference kicked in, all I do is resist, resist, resist – at some level dragging myself kicking and screaming through the process. He just waits. and waits. and waits. He is very firm and boundaried. But I think he has waited and allowed me to play all my resistance/avoidance ‘tricks’ until even I start to see them for what they are. It’s so mad – at an intellectual level I can see whats going on to some extent yet emotionally/psychologically I revert to very regressed place and resist everything.
I was dreading the Christmas/New Year break of two weeks (ie four sessions). He is bringing me back just before two weeks – so we just would have a 3 session break, which is very kind of him and I really appreciate it. I would hope that in time I would feel less devastated by breaks. I got right into the painful feelings of separation at last session before break and it armoured me for the holiday… in that I was able to sort of ‘switch off’ the trans neediness for 10 days. I was busy with house guests but was so relieved the obsessive neediness for my analyst had subsided. But just two days ago, with my first post-holiday session in sight, the trans feelings came back full volume. I dread going back to this merry go round of neediness again.
During the holiday, I was very low with suicidal ideation and a stupid event of mild self harm. I felt annihilating loneliness, isolation and hopelessness – not to do with my analyst being away but with issues in my real life. I don’t want to tell him about the self harm as all that is ‘forgotten’ since the trans feelings came to surface again. But I will but feel there is no escaping its going to be viewed in light of the break.
I feel physically ill almost – churned up stomach and over excited at thought of seeing him again in one days time. YET by time session comes around, I could well be resistent and fed up with him – I do feel a bit angry by my trans feelings for him and how they take over. I have told him this and he replied ‘I think you are feeling more than a little bit angry” in his mild gentle tone. He is very good. I have no doubt about that. But sometimes I feel I am going mad with the transference. And drives me crazy that I ‘love’ him between sessions and then want to give him a hard time when I see him.
I dont understand how I can be in serious suicidal ideation and despair state one week and then its all suddenly ‘irrelevant’ coz I am seeing my analyst this week. I despair that I can ever really make progress. I am like a baby or 4yrs old with him. I dont function well in between sessions – I just think about him. I gather I am not alone. But I wonder can it all really lead to healing? It seems so nonsensical at present.
Yes, it can lead to healing. Just keep telling him the truth about your experience. It sounds as if you’re in good hands.
I have been seeing my therapist for almost a year now. Ive just been away for just over a month to see family interstate, during which time my therapist was available to call should i need to, aside from her 2 week break over the holiday period. I felt reluctant to call her, and only called her twice. One for good news, the other time for not so good news. I felt that i didnt have a good enough reason too. Even though i was struggling to cope with the huge amount of change, fear and stress. I felt that, because i was the one who had left, i had no right to call. I see her for the first time in over a month in just under a week and im very nervous about it. Part of me doesnt want to go in case something was to happen. Part of me knows this is irrational. And the other part is determined to go, but to keep all our barriers in place. Barriers which my therapist has broken down to a degree, but ive rebuilt during my time away. I think i will go. Ive already put of the appointment for 1 day later. I think she knows me enough to be able to deal with my rebuilt defence line. But i cant help but feel terrified of returning. I wish i could make myself less afraid.
My first thoughts when I read your post were that it’s not clear why you want to go see him and why you don’t want to see him.
If I were you I would write down on a piece of paper “why do I want to continue seeing him?” and “Why do I not want to see him anymore?”. And then write down whatever points come to my head. Once I was done with this I would write down pros and cons for each side. Try it out I say, in case it helps..
Hi Joseph,
I am reading your blog while my therapist is away and it is a great comfort. This is the second time my therapist has gone on holidays and last time was a near-disaster, with me self-harming and then terminating therapy as a result. But this time I have managed to cope. I think I trust him more after 8 months of intensive therapy, plus he did something really clever a few weeks back – he gave me his business card with “I’m here” written on it. It’s like a magical charm. I worked out later that he has given me a “transition object” because I have a lot of trouble believing he is “there” in between sessions.
This time I also checked in with my inner child and asked why she was so upset about him taking holidays. She replied that it was because she didn’t understand why he would take his own children on holidays and not her – in other words, she is jealous and feels abandoned. I love the honesty of children
As someone who has been in therapy with several different therapists, I appreciate this forum for validating the pain of separation that comes with vacations. Its very reassuring to hear other people share the same experiences. Thank you for your role in providing this forum of sorts.
Its easy for me to get bogged down in self-hatred about being needy, which then makes an already bad situation (the separation) worse. Currently I am in therapy with a therapist who is very sensitive to separations, so that helps, but it is wearying and I do wonder how long it will take before the relationship “holds” in between separations. This is not my first time in therapy and I haven’t had the best experiences prior to this one. I have gotten to the point where for me, this may be “the last stop on the train” and if this doesn’t move forward I might just chuck it. I’m pretty functional in the outside world, work as a professional, contribute to society, yada yada yada. If I quit therapy, I’d possibly miss out on some healing/growth, but I think I’d be okay enough. I just don’t want this to go on and on like some sort of treadmill with no end in sight.
I wondered how YOU feel about your clients dependence–is it ever burdensome? Can a client’s dependence ever be considered excessive? What if someone just cannot “handle” their dependence and self-harms as a result of the stress. Is it possible that some individuals aren’t suited for psychodynamic therapy and might become worse? Or do you think that in the hands of a skilled therapist that anyone can benefit?
I guess I ask these questions as I ponder whether I am truly suited for psychotherapy, and what makes for a person who is well suited to benefit? As a repeat customer, I don’t want to keep buying something that doesn’t add to my wardrobe–so to speak.
I realize this is an old post and may not get any responses, but on the off chance that someone is reading old posts, would like to hear what people think.
With clients who self-harm, I won’t see them less than twice a week because there isn’t enough contact to support them when dependency comes up. It’s important when beginning work to make sure you have the conditions necessary. I won’t accept a client who can’t come often enough because I know the therapy will fail.
I don’t ever find my clients a burden, in large part because I have a very clear idea of what I can and cannot do. I’m only able to be of use during those 50 minutes when we’re working together and I don’t expect myself to do more. If my client seems to be emailing and reaching out A LOT between sessions, I take that as a sign they need to come more often.
Thanks for the article. Reading it and others responses makes me feel a little better. I found this because I’m really struggling with my therapists schedule which leaves me with similar feelings. I have an appointment every 2 weeks. My therapist never suggested to me how often I should come when I started even though I asked about 3 times. I’ve been trying not to avoid my feelings finally the last couple months so with my feeling being more prominant, now waiting 2 weeks with my feelings is really, really tough. One of my biggest issues I believe is not wanting to be alone with emotional pain. Now I feel like I want to or need to come more often for therapy, I can’t because my therapist is so booked, his schedule has almost nothing for 6 or 7 months unless there are cancellations which when I get put on a wait list, I rarely get called.
I tried to see about interviewing a couple other therapists in the network but I can’t just interview anyone without my therapist releasing me which would put me on a path of a month to get in w/ another if I even liked them and maybe their schedule being tight too.
Anyway, you can get the jist of it, the gridlock schedule and the network ‘system” making it tough just to interview and try out a couple others in the meantime, especially my therapists unavailability if I wanted an extra session or wanted weekly sessions.
A part of me so badly thinks I’d do better with once a week meetings. Another part of me tells me I should use that between week to branch out and find other forms of support too besides just the therapist.
I just really, really wish I had some better coping tools or skills to deal with those abandonment feelings I feel while I’m waiting and waiting what seems like eternity, the 2 weeks long for my next visit. I’m going to talk to him about this next time, in the meantime, I’m really hurting with his lack of “availability”.
You could also use your own funds to shop other professionals without using your insurance. You should let your current therapist know before you do that.
thanks for your reply to my post – yes, I’ve considered that except right now my co-pay is so low. I haven’t thoroughly called around but those who locally list fees on-line are 2 to 3 times as much as my co-pay. The therapist I have now seems ok to me, who knows in network, he may be just as good as the rest of them or better. I’m gaining ground and making some progress so I’m going to talk to my therapist about my feelings at least and stick it out with him maybe 3-6 more months and can always change my plan then if I’m still having trouble. Maybe something good can come out of talking to him. I think I’d be ok with the every 2 weeks in the long run if I could just learn better coping skills for the “left alone with no one to talk to” feelings.