David Baxter PhD
Late Founder
How to Cope When Your Therapist Goes on Vacation
August 1, 2006
With the start of August, many people are planning vacations, including many psychotherapists who'll shutter their offices and leave their patients to fend for themselves.
For decades, mental-health professionals have been getting away during August, sometimes to symposiums in Cape Cod and other picturesque parts of the country that promise continuing education and a relaxing summer vacation.
Some used to leave for the entire month, therapists say, but such a lengthy hiatus appears to no longer be the norm.
"Still most of us take some break in the summer," says Dr. Carolyn Robinowitz, a psychiatrist in Washington, D.C., and president-elect of the American Psychiatric Association. "That's when it's easier to get away; children -- if you have them -- are out of school, and other people are willing to cover for you. And I know my own patients take time off in the summer."
If you're in therapy, experts say, you needn't come unhinged at the thought of your therapist going on vacation, or morph into the nightmare patient in the 1991 comedy, What About Bob?, who was so dependent on his psychiatrist that he tracked him down during his family vacation.
While the movie went for laughs, some patients do struggle when their therapists are away.
The therapist-patient bond is often "an intense and vital relationship," says Jonathan Jackson, director of the Center for Psychological Services at Adelphi University in Garden City, which trains doctoral students in clinical psychology. "You're talking about everything -- love and other passions, death and other losses, and how to live a meaningful and productive life."
For some, he says, even a temporary interruption of that relationship can be a hardship.
The majority of patients will do fine when their therapists go on vacation, but it's a different story for a few, Jackson says. "There are people for whom the relationship is sustaining. It's vital. It sustains them in a way that they can suffer a breakdown without it."
Psychotherapist Nina Danielson deals with that issue in her forthcoming book, What to Do When Your Therapist Isn't There, (Hatherleigh Press, $15.95), set to hit bookstores this week. Danielson, a Manhattan native who now lives and practices in Cape Cod, describes her book as a how-to guide to help patients cope when they're on their own. Originally, she says, the subtitle was going to be If It's August, You Must Be Having a Breakdown, because the running joke is that "August is not a time that you want to get into any deep emotional troubles if you live in New York, New Jersey or Long Island."
Patients don't need to be like Bob and go away with their therapists on vacation, she says, but they do need to feel the connection still exists when the doctor's away.
On Call -- and Not
Mental-health professionals, including psychiatrists, psychologists, social workers and nurse practitioners, may approach vacations differently, depending on their training, experience and personal preference. Typically, they will have a colleague cover for them while they're gone if patients need ongoing care or in case emergencies arise. Opinions vary about how much contact -- if any -- they should have with patients while they're away.
"There are a lot ... who will not accept phone calls at home, who tell you in an emergency, 'Contact your local emergency room, don't call me at night, don't call me on the weekends, don't call me when I'm away,'" Danielson says. "I'm one who permits it because I believe it's more than a 50-minute-a-week relationship."
When she goes on vacation, Danielson says, she gives her patients her cell phone number -- just in case.
"I know a lot of therapists don't, and I know they need their healing time and time to be replenished so they have more to give when they come back," she says. "[But] if I was in crisis, I would not want to call a complete stranger. If it's truly a crisis, I want them to feel there is a connection and I haven't fallen off the face of the Earth."
Robinowitz says she and other therapists who have a medical background are used to being on call for their patients.
"We believe illness and care exist 24/7. You may hear something different from people who come from other disciplines," she says. "We see people on the weekends if need be. We talk to them at night."
Not comfortable cutting patients off cold, but also not wanting their cell phone calls intruding on her vacation, Robinowitz says she gives her patients alternative ways to be in touch.
"If they know they can leave a message on your office voice mail or you've worked out something before you go, that tends to be better for their safety and your relationship," she says.
Ultimately, she and others agree, the therapist's job is to help the patient get along without them -- whether it's the days between office visits or during an extended absence.
Whose separation anxiety?
Jackson urges therapists to look at their own motivations if they're trying to stay in touch with patients while they're supposed to be on vacation.
"We sort of have to ask ourselves as professionals, are we supplying something that the patient genuinely needs -- that is, a vehicle for contacting us if they need to -- or are we in some way dealing with our own difficulty in separating from and letting go of our work?"
Ellen Kanner, a clinical psychologist with a private practice in Huntington, says she takes vacations a week or two at a time. Earlier in her career, until a colleague advised her to stop, she would check her voice-mail while she was away.
"He asked me, 'Would you advise a patient to check their work voice mail while vacationing?' I had to admit that he was completely right," she says. "I feel I have to take time for myself. This is very intense work. If I never take a true break, I don't feel I will be able to function at the level that I need to function for my patients when I return."
In addition to having colleagues cover for them during vacations, psychiatrists try to ensure their patients have enough medication to get them through, while psychotherapists sometimes take time to emotionally prepare patients for whom the separation could be most difficult.
"The patients who clearly are more psychologically and mentally stressed, they do need preparation," Kanner says. "I always prepare them weeks ahead when I'm going to take a break. I spend time reminding them what they've learned from therapy. It helps them remember that's what they'll do when I'm away."
She also suggests patients continue with their regular routines during her absence. And if anxiety arises, she recommends they do things that will calm them, such as working out at a gym or taking in a relaxing movie.
"They kind of have a working list of things to rely on if they get into an emotional hot spot," she says.
What about when it's the patient who's on vacation? "They should eat, drink and be merry and not talk to a psychologist," Kanner says.
But since vacations aren't always stress-free or predictable -- fights can break out between parents and children, marriages may hit a snag from too much togetherness -- she says patients also can call for a brief check-in with her or schedule a session over the phone if they need to.
While some patients struggle while their therapists are away, others flourish, Jackson says.
"There are people," he says, "who surprise themselves -- and you -- and they do things in your absence that they've never done before. They make strides. They get emboldened. They ask the person out they were afraid to ask out. They ask for the raise they wanted.... For some, the separation is a golden opportunity, a moment to try out what they've learned in therapy. For others, separation is a rainy day: just something to get through."
Tips to See You Through
Nina Danielson, a psychotherapist in Cape Cod, offers some tips that patients can use while their therapists are away:
August 1, 2006
With the start of August, many people are planning vacations, including many psychotherapists who'll shutter their offices and leave their patients to fend for themselves.
For decades, mental-health professionals have been getting away during August, sometimes to symposiums in Cape Cod and other picturesque parts of the country that promise continuing education and a relaxing summer vacation.
Some used to leave for the entire month, therapists say, but such a lengthy hiatus appears to no longer be the norm.
"Still most of us take some break in the summer," says Dr. Carolyn Robinowitz, a psychiatrist in Washington, D.C., and president-elect of the American Psychiatric Association. "That's when it's easier to get away; children -- if you have them -- are out of school, and other people are willing to cover for you. And I know my own patients take time off in the summer."
If you're in therapy, experts say, you needn't come unhinged at the thought of your therapist going on vacation, or morph into the nightmare patient in the 1991 comedy, What About Bob?, who was so dependent on his psychiatrist that he tracked him down during his family vacation.
While the movie went for laughs, some patients do struggle when their therapists are away.
The therapist-patient bond is often "an intense and vital relationship," says Jonathan Jackson, director of the Center for Psychological Services at Adelphi University in Garden City, which trains doctoral students in clinical psychology. "You're talking about everything -- love and other passions, death and other losses, and how to live a meaningful and productive life."
For some, he says, even a temporary interruption of that relationship can be a hardship.
The majority of patients will do fine when their therapists go on vacation, but it's a different story for a few, Jackson says. "There are people for whom the relationship is sustaining. It's vital. It sustains them in a way that they can suffer a breakdown without it."
Psychotherapist Nina Danielson deals with that issue in her forthcoming book, What to Do When Your Therapist Isn't There, (Hatherleigh Press, $15.95), set to hit bookstores this week. Danielson, a Manhattan native who now lives and practices in Cape Cod, describes her book as a how-to guide to help patients cope when they're on their own. Originally, she says, the subtitle was going to be If It's August, You Must Be Having a Breakdown, because the running joke is that "August is not a time that you want to get into any deep emotional troubles if you live in New York, New Jersey or Long Island."
Patients don't need to be like Bob and go away with their therapists on vacation, she says, but they do need to feel the connection still exists when the doctor's away.
On Call -- and Not
Mental-health professionals, including psychiatrists, psychologists, social workers and nurse practitioners, may approach vacations differently, depending on their training, experience and personal preference. Typically, they will have a colleague cover for them while they're gone if patients need ongoing care or in case emergencies arise. Opinions vary about how much contact -- if any -- they should have with patients while they're away.
"There are a lot ... who will not accept phone calls at home, who tell you in an emergency, 'Contact your local emergency room, don't call me at night, don't call me on the weekends, don't call me when I'm away,'" Danielson says. "I'm one who permits it because I believe it's more than a 50-minute-a-week relationship."
When she goes on vacation, Danielson says, she gives her patients her cell phone number -- just in case.
"I know a lot of therapists don't, and I know they need their healing time and time to be replenished so they have more to give when they come back," she says. "[But] if I was in crisis, I would not want to call a complete stranger. If it's truly a crisis, I want them to feel there is a connection and I haven't fallen off the face of the Earth."
Robinowitz says she and other therapists who have a medical background are used to being on call for their patients.
"We believe illness and care exist 24/7. You may hear something different from people who come from other disciplines," she says. "We see people on the weekends if need be. We talk to them at night."
Not comfortable cutting patients off cold, but also not wanting their cell phone calls intruding on her vacation, Robinowitz says she gives her patients alternative ways to be in touch.
"If they know they can leave a message on your office voice mail or you've worked out something before you go, that tends to be better for their safety and your relationship," she says.
Ultimately, she and others agree, the therapist's job is to help the patient get along without them -- whether it's the days between office visits or during an extended absence.
Whose separation anxiety?
Jackson urges therapists to look at their own motivations if they're trying to stay in touch with patients while they're supposed to be on vacation.
"We sort of have to ask ourselves as professionals, are we supplying something that the patient genuinely needs -- that is, a vehicle for contacting us if they need to -- or are we in some way dealing with our own difficulty in separating from and letting go of our work?"
Ellen Kanner, a clinical psychologist with a private practice in Huntington, says she takes vacations a week or two at a time. Earlier in her career, until a colleague advised her to stop, she would check her voice-mail while she was away.
"He asked me, 'Would you advise a patient to check their work voice mail while vacationing?' I had to admit that he was completely right," she says. "I feel I have to take time for myself. This is very intense work. If I never take a true break, I don't feel I will be able to function at the level that I need to function for my patients when I return."
In addition to having colleagues cover for them during vacations, psychiatrists try to ensure their patients have enough medication to get them through, while psychotherapists sometimes take time to emotionally prepare patients for whom the separation could be most difficult.
"The patients who clearly are more psychologically and mentally stressed, they do need preparation," Kanner says. "I always prepare them weeks ahead when I'm going to take a break. I spend time reminding them what they've learned from therapy. It helps them remember that's what they'll do when I'm away."
She also suggests patients continue with their regular routines during her absence. And if anxiety arises, she recommends they do things that will calm them, such as working out at a gym or taking in a relaxing movie.
"They kind of have a working list of things to rely on if they get into an emotional hot spot," she says.
What about when it's the patient who's on vacation? "They should eat, drink and be merry and not talk to a psychologist," Kanner says.
But since vacations aren't always stress-free or predictable -- fights can break out between parents and children, marriages may hit a snag from too much togetherness -- she says patients also can call for a brief check-in with her or schedule a session over the phone if they need to.
While some patients struggle while their therapists are away, others flourish, Jackson says.
"There are people," he says, "who surprise themselves -- and you -- and they do things in your absence that they've never done before. They make strides. They get emboldened. They ask the person out they were afraid to ask out. They ask for the raise they wanted.... For some, the separation is a golden opportunity, a moment to try out what they've learned in therapy. For others, separation is a rainy day: just something to get through."
Tips to See You Through
Nina Danielson, a psychotherapist in Cape Cod, offers some tips that patients can use while their therapists are away:
- Keep a journal. Write down your feelings, thoughts, details of any dreams and any major events. You'll have plenty to talk about when your therapist is back in the office.
- Take care of yourself. Tell yourself, "I can cope," and "I am strong." Danielson adds: "If you're panicked and you're telling yourself, 'Omigod! Omigod! Omigod!' then you're not self-soothing. Parent yourself when your therapist is gone in the way you would parent a beloved child." Learn to do that even when your therapist is around.
- Don't isolate yourself. Reach out to others, including friends and family members, in your support network, but avoid the temptation to use them as stand-ins for your therapist.
