Vacation Breaks in Psychotherapy and Defenses Against Need

In 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.

Joe is the author and the owner of AfterPsychotherapy.com, one of the leading online mental health resources on the internet. Be sure to connect with him on Google+ and Linkedin.

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168 comments

    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.

    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!

    My therapist is on vacation as well and I’m not going to be seeing her for 2 whole weeks. Which I’m already having a really tough time with Realizing that I will be on my own having to hold all my feelings in. When I read what you said about how you only depend on your clients for your income. That makes me feel sad because it makes me think that you guys don’t really care about your clients, and you guys only care about money. I don’t want that to be true, because in a way when u tell someone all your personal secrets and
    problems u come to think of your therapist as a friend kind of figure. Also, when you said that when your therapist is on their break it can bring up feelings of abondment; I don’t think I ever have been abonded by anyone and yet I have these strong feelings that when my therapist is gone, she is abandoning me and leaving me all on my own, and that she doesn’t care for me. I know it’s not good to depend on someone so much like that but she is the only person that I can really share most of my inner thoughts with. Sorry for this being long, I just had to get this all out. I did read your whole article as well. I hope you can try to respond to all this, thanks.

    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.

    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.

    it might be good for you to take better care to take time off if you’re sick. we can handle it. in fact, it might be a good experience to work out in the next session. we like to take care of you by knowing you take care when you need it, that our neediness wouldn’t prevent you from recuperating from being sick. you aren’t “really” our mother, ya know.

    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!

    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.

    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.

    I can relate to pretty everything you’ve described. With me and my therapist going on vacation several times in a year, breaks are nothing unusual to me. It didn’t seem to upset me in such away in my first year in therapy (that is it did somehow, but caused a different reaction). After finding myself all churned up inside during his first vacation this year and despite coping much better the following time, I’ve experienced a sort of slowing down in the flow of our discourse. It looks as though it took extremely long to warm up again, feeling the need to update my therapist on the one hand and having trouble going in depth on the other hand, even though I desperately want to and still perceive my therapist as the only person I could really do it with. I’ve recently realized that I have “withdrawn to a protective place […] protecting myself from feelings of abandonment”. He’s tried to be very considerate about announcing cancellations since I told him, which is wholesome and soothing, but still I fear the next break, now the process just seems to “get going” again, will bring a new slowdown.
    Also I resonate with your final lines about “longing for touch, […] not an erotic [one]; rather, a longing for a hug, an arm around a shoulder, a kiss on the head. A parental kind of love”, this not from my therapist (I couldn’t really imagine him doing that and guess it would feel pretty awkward if he did), but rather from friends I really feel close with.

    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:-(

    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?

    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.

    This post has made me realise how well my T manages breaks. He takes two weeks at Easter, in summer and at Christmas, plus a couple of one-week breaks. I have a printed list of all his vacation dates for the year and he starts reminding me several weeks ahead of each break that we’re going to be off. He always says we, not I, which I like because it implies we’re both having a break and a rest. I find breaks emotionally hard but I don’t begrudge my T his breaks – I want him to look after himself.

    So my T is consistent and reliable like a good parent. But I find that hard to believe and am therefore terrified he will be called for jury service (which can last ages in the UK and it’s hit and miss whether Ts can get out if it) or that he will die.

    Hello Joseph, i’ve been in psychodynamic therapy for 9 months, and still struggle with some trust issues. What concerns me though is how i have recently felt with regard to my therapist having a two week break. There has been an unsettling period with a move for the therapy department, which meant a week break, also the easter holidays which meant another break, then my therapist canceled because of attending a course and now this two week break. I totally understand breaks are needed and sometimes cant be helped. However there is a part of me that feels my therapist wants me to go away, that maybe i am not worth his time. I know it a bit stupid me feeling these things but the frequent breaks recently , have made me feel i am unable to talk about the things that are buzzing around in my head , i feel i am scared to start to discuss something that to me isnt very nice to be left with no follow up week, no continuity.
    Basically i am playing with the idea of giving up the therapy, i dont feel i know where i stand and it feels there is no stability at the moment. My therapist now knows i struggle with the breaks but he also knows that giving me a weeks notice for his holiday vacations maybe isnt enough for me to get my head round it. Im sorry if i have waffled on however i hope what i have written makes sense.

    When confronted with breaks and uncertainty, it’s not unusual for a client to want to end the therapy relationship. Even when I give plenty of notice, there are some clients who want to stop therapy just prior to or after my vacation breaks. My advice is to hang in there and discuss this with your therapist.

    I came across this blog after searching for tips on how to deal with my therapist calling in sick. It put into words what i couldn’t. This was my last appointment before I leave for a trip home to see family for two weeks. I was surprised at how upset I am about this cancellation. I never let myself depend on others, and to find that I have done so with her came as a surprise. I deal with major anxiety/panic issues and a dissociative disorder and this has me spinning pretty hardcore into that. I also SI, and am trying not to let this be an excuse to do so. I wish I weren’t so dependent on the sessions. And I wish I had some coping mechanism to deal with the cancellation.

    You need to take this up with your therapist. If she’s cancelling on short notice and proving herself to be unreliable, how are you to feel safe enough to explore your feelings of dependency?

    I’m dealing with a real challenge communicating with my therapist right now, and I have definitely been tempted to quit therapy many times during the past couple of months as I feel so exposed, frustrated, and misunderstood at times. Yet I continue to do the work.

    This weekend though, another hurdle. I have PTSD, struggling with terrible intrusive thoughts right now. My therapist offers email sessions (paid) when not available for real-time chatting. I sent an email about these thoughts, she completely misunderstood it, so I rewrote it, then she said she understood, but offered no help for the actual issue. I told her I needed something concrete to help me- even some hope of a process/technique/strategy/partnership of any kind to deal with these difficult intrusive thoughts would have been so helpful. But instead, she sent me a song, which was comforting, but not much in the way of therapeutic value, and that’s all I ended up paying for:
    1. misunderstanding
    2. Statement that she did finally understand
    3. Youtube song link

    I’m so frustrated, paid for another 1/2 hour of her time, trying to explain why I feel let down to her, and nothing was resolved. She admitted she didn’t want to deal with the issue via email, but she never stated that in the actual email. She said she didn’t disagree w/me that the email was not therapeutic. She said she’d offered to chat w/me, but as I clearly explained, I had family commitments, hence the reason for sending an email at a convenient time, since I couldn’t chat during the 1 hour she was available.

    At the end of the 1/2 hour I told her I quit again, but relented in an email and asked her if she did have anything in the way of something concrete to offer me in terms of making some progress in reducing the issue I have with intrusive thoughts.

    I don’t know what to do. :(

    You might need to be more patient and wait for her understanding of you to evolve more; you might also have to accept that sometimes, she doesn’t have exactly what you want when you ask for it.

    I enjoyed reading this essay and it made me feel like I was not so alone right now. My therapist is on vacation, only gone for a week, but I’m having a really difficult time with it. I’m not happy that he is gone and that there will be no form of contact this week, but I understand why people go on vacation, and I understand his not wanting to check his emails while he is on vacation. However, I can’t understand why he didn’t inform me of this until the very last minute. He knew he was going somewhere, because he had rescheduled one of my appointments for earlier in the week. Then, waited until the following week (2 days before his departure) to tell me he wasn’t here at the beginning of the next week either, a week’s leave all together. He then waited until our final appointment before his vacation to tell me he does not check his email while he is on vacation. I normally see him twice a week and email him between most sessions (in relation to therapy). He is usually extremely in tune with my feelings, available to me, and knows that I have a fear of abandonment, am attached to him, and have a hard time trusting him. Why didn’t he tell me sooner that I wouldn’t be able to contact him for a week? I was in shock and didn’t have any time to prepare or process what was happening and now I have to wait a few days to talk to him about this.

    He was probably tired, overdue for a break, and didn’t have his usual empathic attunement as a result. Just talk to him about it when he’s back and I’m sure he’ll understand your distress.

    Sir;

    I hope you are well.

    I hope also that perhaps you could lend me your opinion on a potentially delicate issue.

    I have been seeing my therapist for 8 months now, once a week.

    He notified me months in advance that he was taking a break of 3 weeks (I was grateful for the courtesy and took it as a mark of professionalism and respect; but ultimately felt it was unnecessary).

    Around this time I would be embarking on a new college course; and other commitments would not only provide me with an informal support network, but also eat into my time and mental reserves.

    I see therapy like a crutch and physical therapy for the mind, when the leg is broken the muscles atrophy, and so the therapist/physical therapist will serve to strengthen the atrophed muscles. With time, patience, diligence and commitment, the patient will then be able to walk on their own feet and unaided.

    I feel content in myself, and have felt like this for the space of a couple of months. I had an appointment yesterday and told him that I was desiring to terminate the relationship, citing the truth: I felt that I had evolved sufficiently to go on my own, and that the new chapter of my life would render it obsolete.

    He seemed a little reluctant with the idea, suggesting tapering off the therapy. My concern now is that he percieves this to be a passive aggressive defence mechanism to undermine his credibility, spoil his vacation or blackmail him. Sir, I assure you, nothing could be further from my mind or the truth. Whilst I am grateful to his support and efforts; a parent must let a child have their independence.

    How firm do I need to be? At what point does the therapists averments of duty of care and concern for patient cross into the distasteful realm of manipulation? I am not suggesting that he is unethical, or manipulative; I just want to be aware of all possibilities to innoculate myself.

    Your input is most appreciated.

    Safety and peace upon you.

    I’d have to know a lot more about the actual issues of the therapy, but the fact that you wanted to stop abruptly, without prior discussion and agreement from your co-partner in the work, would make me wonder whether you are reacting to the upcoming vacation by “leaving first.” It’s very familiar to me; I find that many clients contemplate quitting directly before or immediately after my vacations.

    If you really feel this doesn’t apply to you, then your therapist’s views on your motivations don’t really matter. You can quit whenever you like as your attendance is completely your choice.

    My therapist told me today he is leaving for 6 months starting in a month and a half. Just 2 sessions, ago after 9 months, I began to let go and open up, today I was already feeling kind of hopeless about any good coming of our efforts when I went in, and then this. Should I just quit now? A week was seeming very long, 6 months is like it never existed. In the past I experienced abandonment over and over, and a lot of loss, and I wonder how I am to tolerate this. It looks like I could just give up, leave things as they are, and live out my days in my current state. Why bother to try? Yes, I was offered someone else, after I gave my trust to this person. Who is to say the “someone else” won’t decide to go, too. i already feel kind of crummy because I have to pay someone to listen to me and then they go away, too.

    Thank you for the advice. I know therapists are human beings and have needs and families, too, so I may try the other therapist. Maybe it would even be better, although that seems more an ideal than heartfelt at the moment. Also, I was hoping to get off some of the medication before the departure, too, but maybe that is a bad idea right now. Thank you again, and for the work you are doing!

    In my experience Joe -therapists with a good psychoanalytic background Whether they practice pure analysis as such or not-tend to be more reliable in ongoing availability. I think it’s useful and very important for some potential clients to ASK at first contact- do you commit to long term work of up to x years ( ie number of ideal years you might like to know is minimally possible)? How often do we meet?
    Ie generally once a week minimum to begin. Do I have the possibility of more than one session weekly
    ongoing if that is needed? Are you long established at this location? Are you staying? Do you travel to many conferences at home or abroad which may lead to session cancellations? How frequently? ( Ie consider if potential therapist is away one week in every month or quite regularly on day of your session. What length generally are

    Vacation breaks -ie thanksgiving, summer holidays? IIts not necessarily written in stone but if a therapist takes regular vacations particularly long vacations-you need to know if that suits your therapeutic process. While its USUALLY a good sign if a therwaiting apist keeps updated attending seminars, writing books etc, its not much help to the client if they are regularly absent from the client work as a result. It amazes me how seldom new clients ask such questions of me -it demonstrates how vulnerable a state they are in and a certain blind trust and assumption because someone is a therapist-they will be reliable

    If someone was buying a car -saying in installments- one would ask more questions of guarantee

    Hi Joe
    oh sorry for my tendancy to very long posts. I am using laptop now so at least this will be less messy than earlier.

    I want to say THANK YOU SO MUCH DR. BURGO. And I post on this topic because I first found and wrote on this site, in this topic Jan 2103. Your words and the words of others here not only comforted me and soothed my troubled but it also helped my analysis/therapy to progress when I returned after the Christmas break.

    Too often I post in my dilemmas or sad experiences. Tonight this is about thanking you personally and publicly acknowledging your generosity in running this site quite apart from all you write and share.

    Last Christmas I was having the vacation break from my analysis seven months after I began. I was deeply suicidal that Christmas. I drove around for two hours on Christmas Eve late at night and even chose a song for my suicide which I believed was a matter of careful planning, to complete with determination in the Spring months. I was despairing at missing my analyst but real life problems, surrounded by narcissists made me finally realise ‘I am a piece of shit and nothing is going to work out’. I also self-injured as a way to ease the mental suffering until I could get on with the business of dying.

    I found your site before my resumption of analysis. I was going to pretend to my analyst that I was feeling good, wanted a long break and strategically isolate myself so no-one would feel they had let me down in anyway when I died -ie if they weren’t around me they couldn’t be thinking they ‘should’ have done something more. That’s the scarey part of planning sucides- it can start with depression, then become angry/blaming but as I got more serious – I actually wanted to protect those I love and those who tried to help me by distancing from them for several months first.

    After reading your words ~Dr. Burgo and those of people who shared here – I found a new sense of possibility for living. I dreaded returning to analysis, to the transference, to the pain – having worked so successfully to be determined to die. #But even before my first session back – I was already better in myself because of the wisdom in these pages on this site.

    Roll on 12 months later. I spoke openly and excruciatingly honestly with my analyst about my suicidal ideation. I told him I didnt want to because it sounds manipulative to voice it – either do it or don’t was my motto. Who f******* needs to know? It’s not fair on anyone else to embroil them in my ideation etc etc. My analyst’s response was that it was important to discuss it in detail. He totally held that space for me.

    I have since instigated no contact with N’s in my life. I have completed a postgrad programme. I have become more real in myself. I have peace I have never known before. I have plenty of ups and downs. I am still borderline. But I am coming off my meds, stopped SI, stopped smoking, started regular exercise and enjoying really delicious good food – no junk. ~Well all of this more often than not.

    I upped my sessions to three weekly – yes it hurts financially – I have nothing left over really but my analyst has also been more than generous with his fee scale. I have sent him 100 texts in 3 days in a borderline rage, I have sent him copious amounts of emails and texts every week, I have raged and loved at him. I have called every f****** under the sun. I went to a colleague of his for one session to ‘cope’ with his ‘pissing me off’ and delighted in telling him I was going to see someone to annoy him. I brought toys into my sessions and from the couch flung them back at him and then demanded he give them right back to me. I have been a tantrumming 2yr old, a bolshy teenager, a coldly furious adult, a borderline rage artist, a delightful entertaining hilarious 4yr old. I have given this man a massive run for his money – he knows, I know it and we both know the others knows it too. I fought with narcissists in his professional association – I did everything possible to wind him up, down and inside out.

    I also cried. A lot. And accessed some of the most early infant pain and trauma that has been waiting for expression all my life.

    I whinged for two weeks before the Christmas break about how my life was pointless without him, his cruelty in abandoning me.
    He is also quite a stubborn man, stuck in – never apologies or admits if he made a mistake – just says after I am furious about some real or imagined error – ‘so where are you with that now?’ instead of saying sorry to me- I can now laugh at this and tell him he is a stubborn f”””””.
    His gentle, consistent, warm attentive presence – leaves me nowhere to go except to the source of my pain. I often resist but he has a very gentle, accepting way with my various states and he just ignores the nonsense and hears whats important. I catch him smirking when I am being entertaining but he still focuses on whats important. Now I am more able to focus on whats important and to speak about it more freely without a load of tricks up my sleeve to distract him. They dont work but he very supportively lets me discover that for myself.

    I sent him one of your responses DR. to tell him how to ‘do it right’…. but he didnt bite…

    But he did agree to more weekly sessions and it has been so helpful.

    I have more to do. The infancy stuff is just part of whats needed to work with.

    My internal psychical world is healing very well. I actually relished the full two weeks break despite whinging at him about it – he didnt make any exception to the duration of the break this year – he didnt need to – he knew it and I did too. I think of him -during this break fondly as a support and a truely therapeutic facilitator- the trans has gone into remission and I dread its return after the break. I probably wont speak to him for the first half hour when I go back – my infantile need to penalise him for the Christmas break might emerge.

    I gave him a gift of two very expensive bottles of wine on the last day – beautifully boxed and wrapped (all my own work!!) and the surprise and pleasure in his face was a gift in itself – I said I didnt know if he accepted gifts but I was leaving this one on his door step if he didnt coz he has been so good to me, so containing and has facilitated me to transform many many difficulties in my life in less than two when the previous 20 years of therapy had failed. He accepted the gift anyway and was so graceful in his acceptance – it brought me joy.

    It was funny because I managed to sneak the gift in beneath my coat – it was a big box – and I had some fighting words to say for first half of session then he got me into the real feelings and I got some work done for my benefit. I think he couldnt figure where this beatifully wrapped big box had emerged from and he wouldnt have been expecting it with the grief I gave him over the previous sessions.

    Dr. Burgo – you too have wrapped clients and contributers lives here in optimism, hope and courage tied beautifully with ribbons of your wisdom, honesty and integrity. You are fundamentally such a good person and use your gifts to transform the mental suffering of so many.

    If I could Dr.Joe Burgo, I would wrap your world in 2014 with deep personal contentment, huge professional success and all that you aspire to coming easily within your reach.

    To you I say Thank you for being part of solution, part of my choosing to live and have courage.

    Thank you Joe Burgo,

    Thank you very much.

    xoxoxoxox

    Oonagh

    Dear Oonagh — what a lovely, generous comment! Today is my first day back to work following the holidays and you’re starting my New Year off in very nice and warm way. A Happy New Year to you, too!

    Hi!
    I’m writing a short paper on defenses and breaks in the therapy and stumbled upon this page. Do you have any recommendations for books I could read to learn more about this?

    Best regards
    – Mattias

    Dear Dr. Burgo, I live in Europe and my psychotherapist takes excessive vacations. He is married to a teacher and – because teachers here have A LOT of vacations – he is away a lot, currently he is gone for three weeks and he will be gone for another four to five weeks in summer. Of course he also takes at least a week off in fall (sometimes two) when his wife has her fall vacation, and another two weeks over Christmas and New Year. I am deeply resentful and angry because of the way he handles all this. While he is in town, he wants me to send him short frequent reports on the issues I am dealing with (eating disorder, death of my mother, other problems) , I was supposed to keep him updated on a daily basis, to these mails he responded occasionally). When he goes away on one of these many vacations he takes to keep his teacher-wife happy, communication stops abruptly and completely. I had been happy to comply with his request for this brief written communication and with two sessions a week. I experienced a number of improvements over time, but now I feel that psychotherapy and his constant random and deliberate abandonment is adding another huge problem to my life which wasn’t there before. For instance, communication was already a disaster over the last Easter holidays. After this I stopped communicating with him outside sessions (the little text messages) and refused to communicate during his last summer vacatio (five weeks), which made me feel better. Because if I don’t communicate, it doesn’t hurt that he doesn’t answer. If I communicate and he doesn’t answer or reciprocate, it hurts terribly and I feel deep shame. But after I stopped communicating, he brought it up and criticized me for stopping the communication which I only did to stop the pain and the feelings of shame. So I began to communicate with him again, taking great care not to forget a single day’s message. Now the horrible Easter holidays are here again, he is in another part of the world for more than three weeks and I feel like I don’t exist. I ASKED him how we would continue to be in touch and suggested that I might send him a message once a week (that would have made three short messages altogether, chances were good he could have survived to read them) and asked if he suggested another solution or frequency. He answered that I am welcome to do that, but added he didn’t know how good his internet connection would be. I understood this the way any other normal person would, as meaning that I better not try. So I thanked him and said that the connection could be expected to be bad and that therefore I would not send any messages. Now again I feel terrible, abandoned and angry. I want to terminate, but am held back because I know that I will also feel terrible after termination. I think that therapy should not make me feel so miserable all the time, several times a year and I am resentful about the way he handles his vacations and how he just disappears and expects everyone (his other patients and me) to fend for themselves.
    Is there anything I can do apart from terminating or hopelessly trying to discuss it with him again? I already brought this whole mess up after the last Easter vacation, but obviously without any success, because nothing has changed. I don’t think that bringing it up once more will be any more successful, because he wants to do what he wants to do, as depressing as it is.
    I would appreciate it very much, if you could give me some advice and consolation, because I feel totally lost and I have been feeling like this for a long time now, regarding my ‘therapy’.

    I think that your therapist takes too many vacations and doesn’t respect the needs of his clients. Therapists all need vacations, of course, but given the nature of our profession, there are limits. I would find a different therapist with a more modest vacation schedule.

    I’ve been struggling with 2 concurrent issues; three weeks ago my therapist M moved to another state. It was very hard for me even though I know it was an important move for him; he was one of the best therapists I’ve ever had in years; I’ve shopped around for others, sometimes staying a year or less but never feeling they understood me. Losing him still has me in tears. He referred me to a colleague of his in the same practice. I’d tried his colleague before (before I ever met M) and had dumped him also because I didnt feel connected to him. M encouraged me to give it another try and stay with him for at least 2 months; problem is just 2 weeks after M left for another state my new therapist left for vacation for three weeks! Totally sucks! I really feel abandoned. On top of that I was in the hospital from taking a fall outside the grocery store and missing M terribly. At least M told me I could write him (though he wasnt allowed to interfere or initiate emails) and at least the new therapist has been emailing me while on vacation, for the hospital issue and panic attacks. Maybe I’m being a wuss, but its just been really hard to feel so left/lost during difficult times. Also how do you alleviate the crying /pain from therapy termination due to a therapist move? I cry alot of nights missing M still. Thanks

    Hi Dr, Burgo,

    I’m glad I found this article. I’ve been seeing a (Christian) therapist for 4.5 years, and although I like her as a person and she’s good for talking to about relationship problems and other situations happening in life, I’ve been frustrated that we don’t get more “done”. Like I’ve needed more help for a long time and although we’ve talked about it many, many times and for about 1.5-2 years, she has never gotten me into an intensive outpatient program. When I first started seeing her it was a few months after I quit my job, and then I was unemployed for a whole year, then had a job for a year and then was unemployed again and have been unemployed for 2.5 years now b/c of depression and anxiety, etc. And I’m only 29. The goal in seeing her was to treat both of those and to be able to work like a normal person but being unemployed (except for babysitting thurs. mornings) for 2.5 years has been awful. (I have a degree in English and worked from age 21-24 except for 5 months of being unemployed. And I didn’t work full-time, at the most 30 hrs. a week. I also have arthritis which makes working hard sometimes.) My parents and I have been unable to get me into the program b/c of filling out the paper work, etc. to get medicaid so that we can pay for the program. I’m not thinking clearly a lot of the time and my parents just don’t do it which is sad. My parents have money saved from having good jobs before but my mom’s retired and money is tight now, and they are paying for everything for me, which stresses me out. They have a bunch of savings but I worry we’re just eating away all our money and they won’t have enough for their future. My Dad is working 50 hrs a week. I don’t understand why in all this time she hasn’t done it, while I’m really struggling, unable to even get out of bed every day and sleeping all day sometimes. I’ve seen her once or twice a week for these 4.5 years (1-4 hrs a week). I’ve often wondered if it was helpful or not and at times she’s made me really upset and other times I’ve really enjoyed going every week. I’ve been so confused but I’ve stuck with her b/c of her knowing everything about me and not wanting to start over with someone else and I guess I’m attached to her. Last Oct./Nov. I stopped going to her b/c we had an argument and things weren’t going well…I saw her once in Nov. and once in Dec. and then just stopped going or talking to her cause I was so frustrated. Those 3 months were awful though b/c of something that happened in my life in Oct./Nov. I really needed to talk to a counselor about it so out of desperation I went back to her in March b/c she knows me and knew about the problem somewhat already. Things have been better since I went back and she has been more helpful. I felt like things were finally starting to get better in my life, but I’m still at a critical spot b/c I still need to figure out if I can work or should do a program. And then last week all of a sudden she told me she’s been trying to adopt a baby for 4 years and finally has a match but it’s due June 21 and would prob. be due early. Then I found out fri. it’s definitely happening and next week is her last week. It’s exciting for her but I’m furious b/c I feel like that’s really unhealthy/unfair and sudden for her clients, especially me. I feel really hurt and like she doesn’t seem to care much about how it affects me. She said it’s ashame it’s happening this way but they may not find another match. I just can’t believe she would even take it if it means giving her clients only a week’s notice with all there is to finish up talking about, like my parents were supposed to come in for family therapy still. I don’t have a job and I can’t believe after 4.5 years and $20,000+ I’ve never gotten into a program and gotten the help I need. I don’t think she really understands. She said she’ll communicate with my sister-in-law to have her help me get into the program, and will give me a recommendation for a counselor to see for the 3 months she’s gone. I just feel like this is horrible timing for me, and the next few months are extremely important as I’ll be turning 30 and I want to be healthy and have accomplished much more by then. We are supposed to meet next week for the last time and I said we needed to meet with my parents before she goes but also talk about another important issue, and she said we’ll try to do both in the same 1 hr session! I’m like, really? I’m frustrated that there isn’t time to cover all the important things we should cover before she goes. And I feel so hurt and angry I don’t even want to talk to her again or meet next week, nor go back to her after 3 months, which doesn’t even make sense to me. It’s hard b/c I’ve depended on her to be the person I see consistently and tell everything to for so long so it’s really hard to just cut that off, let alone her be gone for 3 months. She’s been the most consistent person in my life the past 4.5 years, and now I feel like she’s just another person that I trusted and got close to only for them to leave in the end at the drop of hat and not even seem to care. It makes me not want to trust anyone again. B/c this has happened during my time with her with friends and different guys, all which I’ve told her about. And now she’s doing the same thing. What do you think about all this? Is it right/professional/healthy for her to leave on a weeks notice for 3 months like that? What should I do? Also, whenever she went on vacation she would only tell me the session beforehand. She would just say at the end of the session, oh I won’t be here next week, so let’s schedule something for the following week. And that always annoyed me. Is that right? Also, I’ve felt suicidal at times which she knows about. I never actually attempted it just thoughts a lot of not feeling like living anymore and feeling like life is meaningless and aimless. That’s why things have dragged on for 2.5 years. She’s seemed like she really cares about me, and it was good for me to see a counselor I thought b/c I’m not close with my parents and can’t really talk to them about deep things. But then things like this have happened that seem cold and like she doesn’t care that much. Now I feel like I’m just a job to her and she doesn’t really care that much what happens to me which is really surprising after all we’ve been through and her seeming to really care before. But I’m also thinking, if she really cared, wouldn’t she have gotten me into a program a long time ago? Thanks for reading! I know it’s long.

    And oh yeah, she said normally you get much more notice like 2 or 3 months, about the adoption so this was really last min. I just feel like why won’t she trust God that a better option would come up not so soon that’s better for everyone. It may sound selfish, but this is my life too. She’s waited 4 years for a baby but I’ve waited 4.5 years for a normal job (or a job period) and to be normal and we’ve paid her soooo much money and she hasn’t gotten me the help that I need. It’s had a huge affect on my life and I feel like so much of my 20s has been wasted….I never thought I’d be unemployed this long or that my life would turn out this way/so awful. I’m regretting having ever chosen her as my counselor and I’m so frustrated. :/ I feel like it’s going to be awful to start over with someone and have to retell them everything, especially 4.5 years worth of stuff. It’s like I’ll have to spend even more money just to go over the stuff I already spent money telling her, and this is the worst time for things to go backwards/have to spend even more money going back over everything. I need help from someone who already knows me otherwise I don’t know how they can help much at the place I’m in.. :/

    I also kind of feel like I’m worse than when I first started with her, esp. cause I’ve been unemployed for so long and feel so aimless. I also feel almost MORE “crazy” then before I ever went to counseling. There’s something about going to a counselor that automatically makes you feel like a weirdo, which you wouldn’t feel if you weren’t in therapy.

    My shrink has gone away and it hurts a lot. But he has not gone away in a long time. So I am getting panic attacks. I know he will have to step away some time in the future. And it will be for a long time. I wish he would take normal vacations like everyone else. I just don’t know what to do about the panic attacks.

    Interesting post thank you. Is it possible to clarify what is a fair or reasonable amount of vacation breaks/duration? Strikes me that the difficulty with dependent feelings is exacerbated by haziness around this issue of what is reasonable vacation time for a therapist – who is actually fostering dependency in clients (hopefully in order to cure them). The therapy process can seem a little like prescribing a drug and then expecting the user to cope without it when the therapist decides to withdraw. It’s one thing to be aware of that as an inherent part of the process, but it makes little sense to submit oneself to it without clarification as to what is reasonable withdrawal by a therapist and what is not. i imagine this will vary somewhat according to the modality of a particular therapy but it should still be definable by modality I would have thought.

    I don’t think there is any generally accepted standard. In Europe, it is not uncommon for analysts to take a long summer break of six weeks, plus two other vacations of two weeks each around Christmas and during Spring. American analysts take about half that much time off.

    To me, the main issue is advance notice. Clients need to know about breaks far in advance. I think that several weeks during summer plus another two or three weeks throughout the year is acceptable.

    Thank you for your thoughtful response. I think your view is a fair one, and that provided the vacation breaks are not excessive, advance notice is the important factor. I have read texts which highlight the importance of therapists caring for their own wellbeing by taking vacations as required, but I do think an acceptable and accepted standard (similar to your view) would show a respect for both parties and reduce the sense of inequity which can easily arise around this issue.

    First, thank you for having this spacee! After not quite a year in therapy, my first therapist told me she would be leaving for a six month sabbatical. I felt cut loose, but I did have about 3 months to adjust before the actual departure. The worst part seemed to be that old abandonments were a big part of my trouble and, whether she knew it or not, I had begun to trust her literally about 2weeks before “the news.” She is a terrific therapist, but practices in a medicalized group pratice, the atmosphere of which I took to reinforce every visit that there was something very”wrong” with me. She referred me to her friend, a therapist on the other end of the spectrum whose sessions are in her happy home office. We laugh, we work, and I am feeling so much happier, beginning with the new atmosphere. Now I wish the first therapist would get out of that space-she could do so much more for her clients! Maybe it is just my taste, maybe I am just better, maybe I never really did connect that well with her, but whatever happened, I think this is working.

    I don’t know. Fear of abandonment yes but it’s going to happen eventually anyways.
    I hate the control I feel my therapist has. She cares, sure and I care about her but she is my therapist and she will leave. She will talk to colleagues if she has any feelings about the ending of the therapy…I will be in pain and feel a loss. It’s a pseudo-relationship. Not really real. When she goes on holidays I think as your client did….I was fine. Why go back? But I do, every time. She takes holidays but if I take time off I have to respond to why. Not everything I do has to be questioned does it. Mind you I have a very kind and caring therapist but sometimes I just get angry at the dynamic, at the dependance and whatever else all of this is.

    Hi,

    My therapist went on vacation and did not notify me before hand. It’s not the vacation that is bothering me, but the lack of communication. If I don’t tell her I’m not coming and don’t show up, then I still get charged. Shouldn’t this go both ways? Also, it is through a university and they generally only allow clients to have sessions every other week unless there’s some sort of emergency. Is this still beneficial or should I look for something out in the community to get my needs met? I definitely don’t feel like every other week plus vacations is very helpful. Thanks.

    Going on vacation without notifying your clients is unethical and just plain bad practice. Unless I can’t avoid it — say, with a client of long-standing who needs to cut back for financial reasons — I won’t take on someone every other week. It is definitely not enough.

    really, a 10 day vacation is an impossible challenge?! my therapist went on a nine month baby leave at a very unexpected age!! this is me having a “one over y’all” smile =)

    Hi,
    I am in training and I am required to engage in psychotherapy with a patient for 40 sessions. He is in his mid 40s, never been married, is on benefits and has great difficulties/anger towards his parents and society in general as he perceives people to be insincere and manipulative to get their own needs me. He was also adopted out as a newborn, so this compounds his abandonment issues. I am at 19 sessions that are scheduled weekly (about 1/2 way – he understands the time limit). I will be taking a month’s study leave but still plan see him as usually as I want to go on holidays in Sept/October. The problem is that I am planning that my holidays will be about a month with a week either way and I am interested your thoughts on an extended break such as I am planning and how best to negotiate it. I will be discussing this with my supervisor of course. Thanks :0)

    A month’s vacation is not unusual, although it may be difficult for a newer client to tolerate. My advice is to make sure you give lots of advance notice and discuss it regularly.

    Hi, i have such split emotions over holiday times, i have that part of me that really wants him and his family to go because he deserves a good break and i want him to make it in life and for his family not to suffer in anyway from the type of profession he’s chosen, it means he’s looking after himself, which is good, then there’s the other part that gets so restless and edgy and hate that he’s gone, not quite knowing what to do with myself, and i hate that part of me for having the need to have this person around for me to talk to, It makes me feel so weak and pathetic. After my first week or so which is the hardest, i find i pull myself together and do have those feelings at times where i think well i don’t actually need him, in fact going to therapy has just stirred up a lot of things and maybe i was better off without having started it.
    I recently after a really hard session for the first time that i can remember felt the actual feeling of trust not just the concept thereof, it was such an amazing feeling, which my protective self reigned in quite quickly, but i felt it, so when he goes away apart of you wants to pull it back and recoil back into protect mode.
    Why is it so necessary to become so dependant on your psychologist if you know it’s not a real relationship, you know there will be a time when it will end and it will hurt like hell, i don’t even want to think about that time it depresses me, as ive said to him before, if for whatever reason therapy ends abruptly, i would have to do what i think i would normally do to cope, i call it cut and paste, pasting it somewhere else like it had never happened. Like a death and move on.
    I hate this need, weakness to talk to him, I’ve always hidden who i am, you feel so exposed, that someone has the “power to dash you on the rocks” so to speak. I hate feeling so weak It can only end in you getting hurt.
    I have been thinking of cancelling my next session due to finances but maybe it’s also a little part of me that wants to say see i don’t need you! Really How pathetic can one be and still breathe!! A grown adult really !!!

    Why do I feel so awful when my therapist goes on vacation? I despise the fact that I need him to get through the week. I am a wife, a professional, a mom and I do a good job at all of these roles. I’ve won awards in my profession. I have everything I need including disposable income and a very loving husband. How lucky I am to have all this and also the dual diagnoses of severe depression and anxiety. (That was sarcasm.) Sometimes I can cope, sometimes not. I think about suicide all the time. Hence, it causes me tremendous guilt: many people would love to be in my position in life. How dare I even think about throwing that away? His vacation, as much as he deserves it, is affecting my ability to cope. Which causes more guilt. I am grateful therapy works for me and I can pay for it, but maybe I don’t need it and only think that I do…. Does this seem like a healthy Psy D-patient relationship?

    breaks in therapy are confusing for the client. Your article addresses some points but always seems to put the client in a power struggle. It’s always what the therapist wants. Sure they are entitles to time to recuperate, although that feels hurtful as if i am too much for my therapist. So what if your therapist take two 5 week vacations per year but always checks in once or twice and this time did nothing…..????? Should I feel abandoned? I definitely do and the thought of going back as you suggest to talk about it make it feel like a trick. Get me back in there so the therapist can express caring when in reality the caring is not there.

    Thanks for all the great posts. I find your insights to be so helpful. I’ve been reading around neediness in therapy to try and understand my own neediness. I don’t remember any other relationship where I’ve felt this needy. I’ve never allowed myself to need someone. I’ve always struggled to ask for help even though I’ve wanted it and longed for it to be there as a natural result of a mutual connection with someone I trust. I’m realising that maybe therapy is providing me with that opportunity but I’m too afraid to take it because I don’t know what will happen if I truly let myself rely on my therapist.

    Far back in the comments you talk about some clients magically getting better. This happened to me when my therapist was unwell and had to cancel two of my appointments. I remember feeling like I must have made her ill. I blamed myself for the first few days and then was able to look at it more sensibly and acknowledged that everyone is unwell from time to time. Following this I felt the need to only focus on what good had come from therapy, and to tell my therapist all about it and to thank her and thank her for all her help. Prior to her being unwell she had brought up the idea of endings in therapy and made it clear that it was important to talk about so that it didn’t become the elephant in the room, but that it would ultimately be my choice as to when the end comes. I understood exactly what she meant but from the moment that was brought up I have worked hard to distance myself and aim for the end. My plan was to gradually see her less and less when Really I want to continue and feel I have a lot of work left to do. My childhood was crazy from the word go (no mother or father from 7months old, many years of neglect, emotional abuse and 3 different occasions of sexual abuse) and it’s only now that I am beginning to feel like that story is actually my story and really did happen to me. I don’t want to be alone as these things become real and I want so very much to lean hard on my therapist until I can carry my past more comfortably. But I feel so much shame over needing her and worry it’s not normal and find between sessions so hard going because I long for more contact. It feels like a cruel game of wanting more contact but also wanting to run away because of feeling needy. I’m struggling to find a way past this but I need something to budge soon as I’m exhausted with it. Have you experienced this with clients before? Where clients long for more contact? What does that usually mean to you as the therapist? Is it something that makes you uncomfortable? It sure makes me uncomfortable! How do you help your clients experiencing this? Sometimes I just want to go for it. Express to my therapist In a really clear and logical way all that I wish I could have from her, what I feel my needs are so we can discuss it openly and see if she feels she could give me any of it. But I’m afraid of how It would feel if she said she couldn’t meet any of those needs. Does it even work that way in therapy? Having unmet needs from childhood met through the therapy relationship? Is that OK to want that? Can I expect it?

    I’m not uncomfortable with clients wanting more contact and I have seen many people for multiple sessions per week. Unless a therapist is trained to deal with neediness and the transference, however, he or she probably will feel uncomfortable with “too much” neediness in a client. The current professional attitude toward neediness is that it’s bad to encourage it and you should terminate if clients become “overly” dependent.

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