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David Baxter

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When Is It Time to Stop Therapy?
by Deborah Gray
Tuesday, October 31st, 2006

Despite my belief that a large component of depression is biological, I am a strong believer in talk therapy. I have had three therapists, and I?ve been lucky that they were all effective and ethical therapists. I?ve learned a lot about myself, and more importantly, learned to analyze my own actions and feelings and deal with them constructively.

As valuable as therapy is, though, it should not go on forever. As my first therapist told me, ?A therapist?s job is similar to that of a parent ? the goal is to become obsolete.? In other words, while all therapy goals are tailored to the patient?s needs, in general the main goal is to give the patient the tools to handle problems on their own.

If you?re scratching your head at the word ?goal? and asking yourself when your therapist used that word, then you probably want to bring it up at your next session. A therapist should discuss what your goals are when you first start seeing him or her and occasionally revisit your goals to determine how far you?ve progressed toward completing them.

For instance, and let?s take the most difficult example, let?s say you have been diagnosed with depression and it?s been suggested as part of your treatment that you start talk therapy. This is what happened to me. At the time, I had no idea what was causing my depression. This is when my therapist told me that her job was to help me uncover what was causing my depression and help me move past it, and to make herself obsolete. The important thing was that we had a goal, as non-specific as it was at that point.

A compelling reason for keeping your therapy goal-oriented is your insurance company. Nowadays it?s likely that your insurance company is going to require your therapist to state goals for the therapy. What could happen, if the company doesn?t feel that your therapy is on track, is that they will insist that therapy be wrapped up in a few sessions.

Some mental health professionals would disagree with the assertion that therapy should be goal-oriented and argue that the journey of self-discovery can?t be pinned down to specific goals. My second round of therapy was in the psychoanalytic mode, which tends to be the least focused and longest-term, as it involves bringing the subconscious thoughts and feelings to the surface. Even so, we talked about my goals for the therapy frequently, which I think served to keep me on track.

Therapy, even psychoanalytic therapy, should not drag on forever. You should see progress in months, not years. If you are not seeing any progress and your therapist is unwilling to discuss goals, then you should find another therapist. You are not in therapy just to chat for 50 minutes; you are trying to improve some aspect of your life that you?re not happy with or find a reason for your depression.

One caveat is that it?s very common to want to leave therapy when it reaches a crucial point. You?re venturing into scary territory. I always knew that was the case when I was dreading therapy. Normally I either looked forward to it or felt fairly neutral about it. I have known people who left therapy at critical points, claiming the therapist couldn?t help them. This is not a healthy reason to end therapy. Talk to your therapist about your feelings.

It?s possible that you and your therapist will jointly come to the realization that you?re finished with therapy. If you feel that you?ve accomplished what you wanted to, but your therapist hasn?t said anything, it?s up to you to tell him or her that you are ready to leave therapy. Assuming your therapist has your best interests at heart, he or she will be thrilled to hear this.
 

foghlaim

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Good important info here and it's a question often asked..

Thanks for the article .:)
 

Halo

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You are not in therapy just to chat for 50 minutes; you are trying to improve some aspect of your life that you’re not happy with or find a reason for your depression.

This is the part that I found interesting and I could relate to. I was in therapy for years where I was there just to chat and honestly there was not much improvement at all. I am relieved to have moved on from that type of therapy, as painful as it is now.

Great article David, thanks :)
 

adaptive1

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I still find this issue confusing. I have been going back to my therapist for maintenance sessions if you could call them that because of the ?relapse? I had a few months ago before Christmas. Generally day to day I am doing pretty good but after I go for my session, for the next few days I feel quite depressed about what we talked about and quite hopeless about my future. Also, I find the session triggers compulsive behaviour in me that is extremely hard to fight off for a few days afterwards as well, but I have no idea why. Do you think this is a sign its time for me to end my sessions for good, maybe I don?t need therapy anymore? Maybe just talking about the problem just keeps making it an issue in my mind when it might not be if I didn?t talk about it or focus on it?

Any thoughts on this? I am trying so hard now and I can?t afford even mini triggers.
 

ladylore

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It sounds like you may need to be more grounded before you leave the session. It may be a good idea to talk with your therapist about this. Its like you have opened up "luggage" during the session which brought things up but couldn't put it all back in place before you left the session.

A therapists are different by my trauma therapist always does a safe place meditation before I leave - I may feel a bit dissociative afterwards but I know for the most part most everything has been contained before I leave the safety of her office.
 

Halo

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My initial thought when reading your post was when you say that you are doing good day to day whether you are really pushing a lot of your thoughts and feelings down or into a box to not be opened or dealt with. I then wonder when you go to therapy if those thoughts and feelings are coming out or being probed at by your therapist and after leaving therapy it takes you a few days to get them gathered back together and neatly packed back up so you can continue on.

It is just a possibility that I wondered about and it may or may not be the case.
 

adaptive1

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There hopefully I erased my rambling message. If not, please erase it, not one of my shining moments.......

I was wondering if you could make my account so I cant post messages but I can just read them. I am an extremely impulsive person and I dont feel proud looking back at all the stupid messages I am putting on here. I can't be trusted with anything, I have the self control of a two year old.
 
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what if continuing therapy only causes a lot of anxiety and distress (fear) whereas stopping mean no anxiety? i guess what i am saying therapy stirs up feelings and maybe they don't need stirring up.
 

Mari

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H! I have resisted rambling although I certainly feel like it. In consultation with my doctor I stopped therapy just before Xmas with the consideration that I could call any time to resume. I am presently attending a group which meets just once a month. I am looking for something more as a month is too long - I need more support - some days I am just - I don't know - I can not even think of words to describe - looks like :hissyfit: feels like :cry: Mari :heart:
 

moonriver

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Not that I know alot, but for me sticking with the counselling was a good idea. It was good practice in the long run to be forced to confront difficult issues or topics and then learn to deal with the anxiety that comes from this. This is what I was working on in my own therapy when it came to going out into the world and facing situations that involved alot of people which caused me tons of anxiety and shyness. But it gets a little easier all the time. :dimples:

So what if you have a few days where you do some dumb things, or write some silly things in a post, who doesn't. I am not exactly a great writer and its initmidating how smart some people are on here, I am not like.. that but oh well, maybe I can offer something to someone and them to me, thats all that matters I think.

I am not saying what is right for me is right for anyone else, and I am not saying that I have it all figured out, far from it, but if you just ignore the tough stuff and believe you can't deal with it, then maybe you will never know if you could have. You don't have to deal with it all at once and it doesn't have to be all today.... Does that make sense anyone, or did this all sound like one of those whose on first statements?
 
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but if you just ignore the tough stuff and believe you can't deal with it, then maybe you will never know if you could have. You don't have to deal with it all at once and it doesn't have to be all today....

moonriver, this is a really wonderful point you've made here, thank you so much!
 
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Generally day to day I am doing pretty good but after I go for my session, for the next few days I feel quite depressed about what we talked about and quite hopeless about my future. Also, I find the session triggers compulsive behaviour in me that is extremely hard to fight off for a few days afterwards as well, but I have no idea why.

have you brought this up with your therapist?

Do you think this is a sign its time for me to end my sessions for good, maybe I don?t need therapy anymore? Maybe just talking about the problem just keeps making it an issue in my mind when it might not be if I didn?t talk about it or focus on it?

it's a very difficult question to answer. i know that dwelling on the negative doesn't help us move on, and sometimes it is best to just stop thinking about it and get on with life. on the other hand, if an issue is constantly on your mind, and you find yourself going there despite trying to move on, then it may need dealing with.

here's the part i never like when i am told this but: only you can really know the answer. you have to look at your feelings and see what they are telling you.

maybe something to consider would be how would you feel if you did stop therapy right now? would it be a relief? would you feel good? or would you feel negative emotions like anger or anxiety or upset?

here are a few things you could do:

1. discuss this with your therapist and get their take on it
2. you could try reducing your sessions, maybe go from weekly to bi-weekly for a while and then see how you do in the time in between. if you feel better not going than going, maybe you don't need it anymore.
3. may a pro and con list for therapy and no therapy
4. examine how you feel about stopping
5. you can always return to therapy if you feel the need, should you decide to take a break.

i hope this helps.
 
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So what if you have a few days where you do some dumb things, or write some silly things in a post, who doesn't. I am not exactly a great writer and its initmidating how smart some people are on here, I am not like.. that but oh well, maybe I can offer something to someone and them to me, thats all that matters I think.
moonriver, you really got me thinking here, and i would really encourage everyone to post their thoughts on subjects. i always feel the more perspectives are presented, the better, because that gives people more options when trying to figure out a given problem.

maybe I can offer something to someone and them to me, thats all that matters I think.
i completely agree with this :)
 

moonriver

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Nice post Into the Light....

It's nice to have many perspectives. I read things that other people write on this forum where they seem upset about their posts or the fact they are asking for advice and those are the posts that often help me the most. Just knowing that they are working through similar problems or looking for solutions is very helpful. I never feel judgement towards them, just compassion usually for what they are going through.

Adaptive I read some of your posts and you are really tough on yourself, sounds to me like you are doing really well considering. I am much kinder to myself these days and it does make a big difference on how I view myself and others...
 

adaptive1

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Thanks for your thoughts you guys, I guess I should try harder not to get so worked up and quit being so reactive. This is why I am still in therapy, I am working on my impulsive control and not always with great success. I dont know if I didnt go at all if I would have no anxiety as I suggest, probably not because I wouldnt be doing anything to improve my situation.

I only go once every two weeks and I just asked to move it to three weeks. You are right about facing the tough stuff, the therapist challenges me to do things that are hard and its distressful. I also quit taking medication because I didnt like it, I am not sure if that was a good idea or not because that is making things even harder right now. The therapist didnt agree with my decision to do that but it was what I wanted

I will keep trying and hopefully my anxious posts will grown less frequent, I do apologize though. But I have worked extremely hard even if it doesnt seem like it.
 
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no need to apologize, adaptive. that's what the forum is here for, for when we get anxious or worried or we're stuck with a problem that we need support for. working through this stuff is indeed hard work but you are working through it. just be patient with yourself and your progress :)
 
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here are some more thoughts on the subject. i think setting clear goals for your therapy can be helpful in determining when it's time to stop. you might not know what the goals are at first, so that may take a little time to figure out. but once you do, determine for yourself what exactly you are looking to change in your life, or what problems need to be solved. write each of these down. then when you hit a point where you wonder if it's time to quit, take a look at these goals. have they been met? if so, then i would say you've accomplished what you set out to do and therapy is no longer required. if some haven't been met yet, then it's not time yet to finish.
 

adaptive1

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I like your comments Into the Light.......I have to say, it is extremely hard work being "normal" what ever that is. For me, being "normal" means that I am not engaging in obsessive or compulsive behaviour, being extremely self disciplined and filling my time with positive activities helps take the focus off my problems, that has definitely been a major help and therapy has really helped me, more so than medication. I am not sure I am ready to end it yet, hopefully that day will come when I can control my behaviour without external support.
 
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it takes time and effort to change but i have faith that you will get there, adaptive :) persistence is the key, as much as we may want to just give up some days. you'll make it :goodjob:
 

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