11.10.09
When You Suddenly Lose Your Therapist
Posted in Child Alters, DID Education, Depression, Dissociative Identity Disorder, Internal Communication, Self Injury, Therapy and Counseling, Trauma, emotional pain, therapy, trauma therapist tagged AbuseConsultants, AbuseConsultants.com, Anger, Depression, DID / MPD, DID Survivors, dissociative disorders, Dissociative Identity Disorder, emotional pain, Ending Therapy, Grief, heartbreak, Internal Chaos, Internal Fighting, Kathy Broady, Lashing out, Losing a therapist, Loss, Loss of a therapist, Love-hate relationships, pain, Quitting therapy, Saying goodbye, Self Harm, Self Injury, SI, Termination, Termination of therapy, therapy, Therapy Process, Trauma Survivors, trauma therapist, Trauma Therapy at 7:11 pm by Kathy Broady
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Several people that have been reading Discussing Dissociation have made posts and comments about how enormously painful and difficult it is to lose a therapist.
There are several different ways to “lose a therapist” but for the purposes of this particular blog entry, I’d like to focus on situations where there was sudden loss.
In my years of experience, I have seen a variety of circumstances that have led to clients suddenly losing their therapist. When this happened during a long-term therapeutic relationship, the sudden loss is enormously difficult for dissociative trauma survivors.
DID survivors typically trust so few people, and there are usually very few people who are allowed to know the internal system in the way that the therapist gets to meet and know the insiders. It often takes months of regular, frequent sessions for DID survivors to start feeling the teensiest bits of trust with their therapist in the first place. It may also take years of time before some of the more vulnerable insiders experience any feelings of trust at all.
When you find a good therapist that you connect with, it’s usually pretty important to keep that therapist.
But what if something happens and you suddenly lose your therapist?
What if you lose your therapist due to
- An automobile wreck
- An assault of some kind
- An illness of some version
- An unexpected pregnancy issue
- A family member of the therapist is ill
- An unexpected “personal leave” of any kind
- An unexpected “medical leave” of any kind
- The family of your therapist has required a move to another location
In these situations, it is very difficult, but the adult parts of the survivor can often understand the need for their therapist to have stepped out of the office, even for an extended period of time. The loss is still there – and most of the internal system will likely still have enormous grief and struggles and emotional pain. The child parts and traumatized parts might blame themselves, but there will probably be someone in the system that can intellectually grasp that the sudden absence was related to an external issue, and not their fault.
But what about if you lose a therapist to one of these reasons:
- Your therapist terminates with you, even if that is not your preference
- Your therapist quits their job for any number of reasons
- Your therapist takes a new job and can’t take you with them
- Your spouse demands that you stop seeing your therapist
- Another person tells you that your therapist is “bad for you”
- Your therapist gets fired and can no longer work with you
- Your therapist decides they are no longer working with DID
What about situations where it is less externally based and more connected to you?
What does it do to the survivor to lose a therapist?
In my experience, when a DID survivor loses their therapist, especially when there is very little time for a termination or goodbye process, there is a huge emotional fall-out from the sudden loss. The therapeutic relationship is far too important to have a sudden ending, and the emotional overflow will be huge.
The DID survivor tends to:
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- Act out their pain, anger, and fear in various forms of self-injury
- Be unable to move forward in other areas of healing
- Begin to either devalue or overly-pedestal the therapist (the love-hate response)
- Blame themselves or other insiders for the loss
- Cry, cry, and cry
- Experience internal system chaos, increased internal fighting, decreased internal cooperation
- Experience their internal landscapes and internal structures collapsing and the internal world may go dark, or feel unsafe and unfriendly
- Express an ongoing ambivalence towards the therapist
- Feel suicidal
- Go into a long, deep, dark, devastating depression
- Go into hiding – some of the internal parts may refuse to come back out
- Go numb – become more detached or dissociated
- Have a sudden regression in overall skills, abilities, and social interactions
- Have lots of dreams or nightmares about the therapist
- Hibernate within their own home, refusing to go out or interact with other people
- Lash out with inappropriate or excessive anger at innocent people
- Last out with inappropriate or excessive anger at the therapist
- Leave therapy, refusing to trust another therapist
- Lose hold of the positive gains they made with that therapist
- Pretend that the therapist never existed anyway
- Re-create history by remembering only the good events, making the therapist too perfect
- Re-create history by twisting events into something negative, taking comfort by believing the therapist was “a bad guy anyway”
- Refuse to truly leave the therapist alone (following from afar, maintaining contact, calling their phone, sending emails, etc)
- Spend a lot more time sitting, staring, spacing out, etc.
- Stay focused on the therapist, and their feelings about the therapist as their primary issue for an extended period of time
The termination process is as critical to the long-term health and well-being of the client as any other stage of therapy, if not more so. In fact, a very positive therapeutic relationship can become completely tainted and twisted if the termination process is not handled properly.
Cold-turkey terminations are dangerous.
I cannot stress that enough – sudden terminations are not good.!!
They are not helpful.
They are harmful and emotionally devastating for the clients, and they set up the therapists for future problems.
If your treasured therapist has to leave for any reason, take the time to have as many termination sessions as possible. The process of saying goodbye is complicated, but it is crucial to leave your therapist from a positive point of view. Otherwise, you will experience an ongoing emotional fall-out that will extend much further into the future than you would expect.
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By:
Kathy Broady LCSW
pilgrimchild said,
November 10, 2009 at 8:36 pm
i just wahnt sharin. i juist want to go home.
i just want my sharin back i miss her so mutch i dint mene to make her go away kathy you no i did tell you i did try to do evrething rite i tride to do evrething sharin sed to do. we all think its are fallt. evrebody chanjed. sharin leving made evrething fall aprt. we all still have bad drems abot her. lots of bad drems. i just whis her would talk to me. i wish her wouldnt ignorr me. it herts the werst she dint even say bye to me her wont rite me back i wont ever see me aga.n.
i miss her so mutch jo miss her so mutch tuck miss her so mutch. 
she did promiss her wasnt like other pepol but she leid but i do love sharin eneway. we did trust her to not leve us.
the werst thing is she did no waht she was doing. she did no how mutch it did gonna hert us but she did it eneway.
pilgrimchild said,
November 10, 2009 at 8:36 pm
that did be me MAE
from MAE
kindygirl said,
November 11, 2009 at 5:00 am
Very intuitive post, Kathy. It is soooooo retraumatizing when a therapist just suddenly ends things. In my case, my ex-therapist (Stephanie) had threatened to end it with me the entire 8 months I saw her. Everything I did from self injuring to explaining how suicidal I felt was some reason for her “dump” me as a client. It became her leverage and control over me. What scares me so badly is that Stephanie puts herself out there all over the internet as an “expert” in DID in the Atlanta area. She claims to have 30 years of experience in it. She was unethical, scary, and just an all around horrible person. I worry so much about what she’d doing to other women.
She said awful things to me from telling me I gave her sadistic thoughts and that she wanted to slap me until finally she accused me of stealing her clock (it was as ridiculous as it sounds). That was the day I overdosed and she promptly ended therapy with me and never spoke to me again. Anna (my current t) thinks Stephanie is borderline. Maybe she is, but she hurt me a lot because she tricked me by being nice in the begining and when I got attached to her, she turned on me. She would promise to never leave me in one breath and sit and hug me and then tell me she has her “limits” and would stop seeing me if I did x, y, or z. It was such a rollercoaster for me and made me so, so incredibly sick.
I can’t even say anymore….it makes me nauseous.
lostindid said,
November 11, 2009 at 9:13 am
Thank YOU for this post! Very helpful!
I still have a hard time even thinking about John – my T. In 2001 after almost a year together, he asked me if i was ready to open the locked box inside. I was scared, but wanted to with his help, so we set our next appt. to do just that. When i came back 2 weeks later, he had a strange somber look on his face. I sat down & asked what’s up. “I am very sorry to have to tell you we canNot open that box today. I have to move away for another job that will provide better for my family.”
Logically, i understood, but the tears came so fast & hot. Then it was all over. I composed myself, that box was put back inside (who knows where) & the anxiety of opening it was lifted.
He told me that the Only reason why he would stay there (in state & work) would be for Me. I had shared all my journals w/him since childhood to date (something No one is allowed to see) and he said that i am very close to getting the answers i needed & intelegent enough to deal w/them. Out of all his patients, he said that I had the most potential to go off the Rx Drugs and live a “normal” life. He was very sad as was i and it was even more devastating to both of us that this would be our last meeting.
No time for closure of any kind. To this day when i think about John, tears come right away and extreme sadness at losing my only hope for a key to open that locked box.
Yes, i went into a tail spin. Very destructive behaviors, addictions & suicide attempts.
Kathy, You touched a nerve with:
Experience their internal landscapes and internal structures collapsing and the internal world may go dark, or feel unsafe and unfriendly.
Go into hiding – some of the internal parts may refuse to come back out.
Both of which seem to explain the extreme blackness and silence i have been able to acheive. Hasn’t been quite 2 yrs yet since i was able to turn the inside screen off. Was a blessing at 1st, now…it’s causing anxiety, stress & even some paranoia about what “they” are talking about and up to, in addition to the constant lonliness i feel because it is so quiet & black in mind – something i am NOT used to.
still looking for my key…
ME
gobbies said,
November 12, 2009 at 7:14 am
We lost a therapist and a spiritual counselor, both suddenly and bother for different reasons, about 6 months apart. It just about killed us. The T sent us to another T, but we couldn’t trust at all after that and got nowhere with her, stopped seeing her after a few months. Didn’t do T again for a long time… It still hurts so much to think about it. The pain and grief and confusion are still so so so overwhelming. All the reactions you mentioned are there, and some still are even 7-8 years later. It has also impacted our relationship with our 2 current T’s. We are always terrified they will hate us, reject us, leave us. We care so much about getting their approval (so they won’t leave) that it can become the sole point of T for us sometimes. Wow, hadn’t thought of it that way till just then.
Gobbies
pilgrimchild said,
November 12, 2009 at 11:51 am
I don’t know it we’ll ever get over what Sharon did by leaving us so quickly. She was such a good therapist, but to not give us any warning, and to have us come to 1 session and say “I’m DONE” and then that was IT– that was just it, no discussion… it devastated everything. We were suicidal for a year. We lost a lot of weight and became emaciated, and severly depressed. The worst thing was, she knew exactly what she was doing, and she did it anyway. Sharon knew what a hard time we had with people abandoning us our whole lives, she knew how devastating that type of thing was to all of us. She knew. She said she wasn’t going to be like other people. Yet in the end, she was, and she did. That completely broke our spirit and our heart.
Now, even though she was a great therapist, and we did some good work over the 7 years, we cannot think of any of it without severe heartache. We can’t look at any of the old papers we have left (although most of it got destroyed when she left, and she kept most of our stuff, which makes us mad she wouldn’t let us have our stuff, she even kept our coloring book and our collages), we can’t look at any of our stuff because it hurts too much.
It just all hurts too much, and we miss her so,so much. We just want her to talk to us. We just want to tell her so many things, that we still love her and forgive her and we miss her, and we’re so sorry for whatever we did wrong to make her act that way, we’re just so, so sorry for not being good enough.
vickilost said,
November 12, 2009 at 1:31 pm
I suddenly lost my therapist when I was 16. She had become my life line, someone I was beginning to trust. I had kept that I was going to therapy secret from my family. When they found out I was in big trouble and I was kicked out and everything was very ugly and they were very angry with my therapist too. At that time my world had been blown apart and I moved city and lost my therapist and my family.
I found going to therapy again after that difficult because I would always feel that something terrible was going to happen or I would say something terrible that would destroy everything.
I lost my current therapist suddenly for 6 months from sickness. THis was testing as I thought she was never coming back and that she was trying to get rid of me. However we persevered and slowly are gaining trust. But I still have that fear that I will say something or do something and again I will get in big trouble and everything I know will be destroyed….
does that make sense?
oompaa said,
November 12, 2009 at 5:35 pm
my t suddenly went out on maternity leave for adoption. she didn’t tell me until right before she left that she would be leaving. it was very difficult and now i only see her once a week where we were seeing her twice a week. it’s been very difficult, but finding another good t feels almost impossible. still seeing the current therapist who went on maternity leave. just don’t know what else to do. feeling like i should be fine with one session a week and feeling like insurance wouldn’t cover me anyway. now going into the holidays and feeling very scared.
oompaa
pilgrimchild said,
November 13, 2009 at 10:46 am
i wish i could stop thinking about this
jo
soulfulgrrl said,
November 13, 2009 at 2:06 pm
The one therapist that in my mind deserted me was about 8 years ago. She was a student at this Rape and Sexual Abuse Center and she told me that she’d never just desert me. She said that she would never do that. Well, her time was up at the center and she told me about 4 sessions before. However, she lied to me. She knew she would have to leave the center but she didn’t tell me that for whatever reason. Her leaving me was the most painful thing I’ve ever been through in regards to any therapy. Granted the last 4 times I saw her we went to this sacred place in a park and she made me something beautiful and we gave her something (even tho she didn’t know we were a we technically… but i think she kinda knew)… i still have that book she made us and we look at it and feel the hurt all over again. However, a lot of time has passed and I can see a little bit of what happened… the therapist we have now was a student but we were able to go with him to his new place… when she was finished with her internship she couldn’t take us with her because she wasn’t practicing as a therapist. she was a forensic social worker… so she worked for the county. I understand it logically… but it doesn’t make the heart hurt any less… and i think she felt hurt too… but she should have told us… regardless…
soulful
Kathy Broady said,
November 15, 2009 at 12:03 am
Mae,
I do understand how very hard it is for you, missing your t. I am sorry so many things have changed for you after she left. It sounds like it has been very hard and very hurtful for you. I understand that it will be hard for you to trust again — feeling betrayed and abandoned, left and forgotten, is very hurtful. I’m sorry it hurts so much….
Kathy
kesrevive said,
November 16, 2009 at 1:13 am
I have lost many therapists…it began in college when my therapist didn’t know how to handle me (DID wasn’t too known then). I kind of moved therapists through college and until I moved away, I met a new one who actually good identify what was going on with me (DID/MPD) and took me to experts like Jim Friesen. However, at one point, I recanted my abuse because I was so exhausted and that flipped her out. I lost her because of that.
I was referred to another therapist with whom I never bonded. I moved states and was DETERMINED to get better by myself until I had a meltdown and was referred to another therapist. She didn’t specialize in DID but she can now put that on her resume! But when I made a decision to have children, she stopped seeing me. That hurt me but I wanted children more. I still call here from time to time.
But the one hurt I cannot get beyond was the last therapist. I saw her for nearly six years. Unfortunately, we ended up in the same church together because there is only one denomination and she dropped me so quickly – she called me at home and said she was leaving and then quit the practice without another word. She sent me a letter telling me NOT to talk to her or any of her family letters even though we were all in the same small church. She went as far as to uninvite me from a woman’s gathering at her home. It seems on top of years of abuse, suddenly having someone I shared with SO much and turn on me so quickly, it made me feel dirty and shamed all over. It’s been almost three years and it still hurts me SO much. I stopped going to church for awhile because I would just burst into tears. But my children missed church and there isn’t another form of church we attend for miles.
So, now I am starting again with a new therapist and she doesn’t understand that I can’t outright trust her. It’s so frustrating. I do not know how to show her that it’s not her personally I don’t trust; just the circumstances.
I hate therapy for these reasons yet I need it so. It is SUCH a double edged sword.
Kes
rdrunner68 said,
November 16, 2009 at 5:24 pm
What about being so afraid of loosing therapist, I have never lost a therapist we usually left, I never really connected with anyone until now.
I have taken a risk and trusted this T and so far she has not let me down, I have reached out when I need help but all this has left me with a fear that is huge and sometimes paralyzing and when that happens I want to pull back. Rationally I know she would never deliberately hurt me but feelings are very different, and lately rational thoughts and unrational emotions are swirling around and Im so confused and I get so scared. I think if I lost this T now I would never recover at least it feels that way. For the first time ever someone has given me their time and listened which makes me feel worthwhile and terrified at the same time. Very confusing
thelittlestsurvivor said,
November 19, 2009 at 1:38 am
my therapist is on maternity leave for the next 2 months. She prepared me thouroughly told me when she was in her 2nd trimaster, so we had a good 6 months to prepare, the only problem is she prepared me, not the other 38 parts of me. and though most of the adult parts understand, the children parts don’t. they think they did something bad to make her go away and not like them anymore. they refuse to cooperate for the simplest of tasks. in the middle of the night they cry and scream for her, they ask my mum where she is, and my mum shows them how to dial our voice mail, my therapist was lovely enough to leave us a voice mail message on our cell phone so that we could listen to it when we missed her. and even though i say just my smaller bits miss her, i miss her terribly. I’ve had one therapist before that i worked with for 3 years get a new job and she couldn’t take me with her. She gave us a 2 weeks notice, and after that she was gone. We went into basically shock. we didn’t eat, we didn’t sleep. we cried and self injured, and shoplifted and other naughty behaviors. this time its different. we still want to scream and cry and break things and hurt ourselves. but we are constantly reminded that our beloved therapist will come back. in january and if i haven’t self harmed we can eat cupcakes and celibrate one whole year of not self injuring. i am looking forward to january like nobodies business. i miss her so much. i really do. i cry when i think about her. i can’t go to the area where her office is because i start to cry or worry. i don’t take 83 anymore because when i am on that highway i can see her office, adn i don’t see her car which causes a meltdown. it’s not good. but i am trying to take very good care of myself. we have started a blog just for our therapist, she said we could if we wanted and that she would read it when she came back. So everynight we just write to her like she is a pen pal or something. it helps. i liked that you wrote this, it was just right on time.
sallysmith86 said,
November 19, 2009 at 10:01 am
we had a t that was safe and helped us learn what trust was. she was only t that listend she always knowd what was going on and would help us she would even not be scared of the scary ones inside.
the body mom didnt like her and after almost 3 years said that our t was to expensive we were suposed to have a meeting with us and the mom and daddy but never went bacl ever.
we miss her the safe peple always have to go and the scary peple never stop :’(
Elizabeth
Kathy Broady said,
November 20, 2009 at 5:06 pm
Hi Everyone,
Someone recently told me how they were looking at this particular article, and realizing how much it applied to other people who were also emotionally close to them – ie: when the best friend is suddenly ripped away, or any other caring person who had become a positive source of emotional support.
That was an interesting thought, and probably very accurate. Many of the losses and reactions explained in this article about the sudden loss of a therapist would also apply to the sudden loss of any other emotionally important person — or pet.
No wonder loss and grief can be so very difficult….
Ouch!
Kathy
Kathy Broady said,
November 20, 2009 at 5:17 pm
Elizabeth,
I think you’ve made a good point. It is particularly painful to have someone else step in between the relationship you have with another person and through their use of force, or power, or persuasion, they demand or create a sudden ending to an important relationship.
It’s really not ok for the scary people to make the safe people leave….
I hope that someday you will be able to find a therapist and a therapeutic relationship that your parents cannot influence. When you get to have more say so over your own relationships, and the “say so” of someone else is not allowed in, then maybe you can keep your new safe people as long as you want to.
I hope you find more safe caring people soon – and then find ways to fight for that relationship. Don’t let anyone else take it away from you.
Kathy
Kathy Broady said,
November 20, 2009 at 5:28 pm
littlest survivor,
Thanks for your post. You have made some good points.
First of all, you have shown how it makes such a HUGE difference to have time to prepare for the loss. One of the worst parts about the SUDDEN loss is that the person has no time to be ready for that, and they certainly don’t have time to prepare all the insiders for it. So yes, the idea of having some time ahead of time is extremely crucial. You are feeling the pain of her loss, but it doesn’t sound like you are self-destructing this time – what a huge difference!
And of course it is hard even when the treasured person is away. There will be pain, there will be upset, depression, sadness, etc. But – having time to prepare, and making arrangements while the person is away also makes a HUGE difference. Your t has done some great things with you by leaving a phone message that you could have as an object to have, and the writing to her as a penpal, in a place just for her, is also an excellent idea. And the fact that she gave you months of notice is also very very good. The fact that she has prepared you ahead of time has really helped in so very many ways.
But yes, of course, it is still hard. There’s no doubt that you miss her. Since you guys forgot to really work with the child parts, you can still do that now. It is important now to also let your littles hear the phone message, and let them type in your t-blog, too. And this is a good time for your adults in your system to work on taking kind gentle care of your kid parts and to teach them about dealing with loss, and reassuring them this situation is different.
January must feel like forever away at this point in time, but you will get thru’ this time, and you can make it a wonderful time of growth too. Work hard at finding ways to make it a time of progress for you and your insiders. THAT would be a nice difference as well.!
Good luck,
Warmly,
Kathy
oompaa said,
November 21, 2009 at 9:34 pm
you say it is the grieving process similar as with any sudden loss? i had a grandmother who was run over by a car. i wasn’t super close to her, but she still meant a lot to me or so i thought. i haven’t felt anything. same with my grandfather who died suddenly of cancer. i feel a little more from my grandfather then with my grandmother but still i have never cried or truly grieved about them. not sure. i mean i actually fall apart over my previous therapist when she retired. is that some sort of grieving process. that was a good termination also. if it is some sort of grieving process then why don’t i grieve for my family. i don’t know. probably way off subject. sorry about that. just wondering.
muffledones said,
November 24, 2009 at 9:48 am
oompaa-maybe alla you didn’t know your grandparents and vice versa, so there was less numbers to grieve. But see T proly knew of the the ‘others’ and they knew of T, so more to grieve.
I dunno just a thot.
pilgrimchild said,
November 25, 2009 at 12:22 am
Regarding what littlestsurvivor said… I think that people just dont GET it… that when they leave the outside/adult body, they think they have prepared that person… they don’t realize that they are leaving many more insiders behind as well. Some realize it…our ex therapist certainly did. She knew what she was doing when she left Mae and Tuck and all the other kids. But when our ex-best friend lef tus all of a sudden… she probably didn’t realize it. She thought she was just hurting one person, leaving one person behind-1 best friend. But the littlest girls thought of her as a big sister. Caroline thought of her as a younger sister. Everyone had a different role that they thought of Katie playing.
So everyone just gets sad and hurt and everybody’s feelings just pile on top of each other…. it gets yucky real fast.