The Difficulty Of Losing A Therapist

Over the past few weeks, I feel that I have been going through what is commonly referred to as “a break up”, one of those horrible experiences that, in popular culture, is often portrayed as a situation that can only be remedied by much crying into tissues and several tubs of ice cream. Now I know what you are thinking, “but Katie, how can you be going through a break up when you yourself admitted the day before Valentine’s Day that you haven’t been in any kind of romantic relationship for over two years” (alright don’t rub it in guys…Jeez).
Well if you thought that, you would be right, no, I haven’t been in a romantic relationship for a very long time (aside from the one I am in wth Helena Bonham Carter that she isn’t aware of…yet), but in the world of mental health there is a common experience that is very like a break up, that being the loss of a therapist.

Now, before I go on I would like to preface this by saying that I do not mean for this to imply that I am caught up in any romantic entanglements with the therapist I am referring to and who is currently in the process of “leaving me” for a new job.
Indeed our relationship is very much the standard “patient/psychologist” affair (perhaps affair wasn’t the best choice of word there…). However, what I don’t think a lot of people understand is just how attached one can get to a person who only hangs out with you every week because they are paid to do so.
It a very odd situation, and whenever a therapist leaves I feel I should deal with it easily, without being particularly bothered. This is after all not a new experience for me, as I have literally lost count of the number of therapists that have left me over the years, (seriously if you rounded them all up you would have more than enough of a cast to put on a performance of Les Miserables and trust me, from someone with a theatre background, you need a lot of people to perform that show). That said I know a lot of people find this a very difficult thing to go through, and rather than it mean we are clingy or weird, I think it makes a lot of sense.

Yes, a relationship with a therapist is strictly professional and should, on paper, be the equivalent relationship to someone you have hired to be your private chef (who is paid for by the NHS because you are mentally unable to sustain yourself alone….I need to work on my analogies…)
The chef turns up at your house because it is their job just like my therapist turns up for our appointments, but when you are talking about your deepest darkest secrets and fears rather than how you like your eggs cooked, it can’t help but become more personal whether you intend it to or not.
In every other professional relationship you have with someone who is being paid to spend time with you, like a chef or a plasterer in your house, the reason for their being there is in reference to something separate, aka food or dodgy walls. With a therapist though, unsurprisingly, a lot of it is about talking about your life. How can that not be personal?
Ok other professional relationships have personal aspects to them as well, a private chef for example may eventually grow to know how much milk you like in your cup of tea without asking every time, yet with a therapist there grows a level of intuition that is less about knowing how you like your tea and more about being able to simply look at your face and know automatically that it is time to put the kettle on (although I would like to clarify that my therapist has never actually made me a cup of tea at all…if you are reading this dear therapist, maybe work on that in your new job). It is that deep connection of being understood as a person, and for that reason of course it can be like a relationship break up when a therapist retires or leaves to get a new job.

Again, of course I am not saying that it is in any way romantic and unlike romantic relationship endings we are not going to be left wondering who gets custody of the kids (we already decided in our first session that I get them Monday to Friday and then she has them over the weekend). Nevertheless I am left wondering what I will do without this person who is currently a big part of my life.
When you see a therapist for a long period of time, discussing your mental health problems/building a therapeutic relationship is sort of like building a house. In the beginning you have an empty plot of land and the patient has a hell of a lot of bricks (bricks that in terms of this analogy represent secrets/thoughts/things that make you as a person). The patient is standing in the middle of this messy pile of bricks without any idea of how to deal with it, so the therapist is there as a sort of builder/tidier to help sort it all out. Every week you both turn up at this plot of land and gradually, the patient hands the bricks individually to the builder. Together you try to construct something that is a little less of a mess, and a little more something you can work in. The more you talk, the more bricks that come out, and eventually the house is finished at which point you can go inside and start trying to make the place liveable. You try things out, experiment with fuchsia walls, checkered wall paper or new therapies and you see what works for you.
Then finally you get to the point where you can both walk into the house (aka brain), and know the insides and outs of it so well that one of you can reference something within the house and the other will know exactly what they are talking about. Refer to the “plant thing in the bathroom” and they know what that plant thing is as well as when in your life you bought it and why it is in the house, just as a therapist will eventually grow to know all about the way your mind works as well as any life events you simply reference to as “that time with the giant squid”. If anyone else comes in the house and you reference the plant thing, they don’t understand exactly what you are talking about. Even if you take them to the room to point it out they cannot have the same level of understanding as the person who helped you build the bathroom in that particular way and find that particular plant at the gardening centre. You can tell a new therapist about what happened during “that time with the giant squid”, but to them it will just be a story rather than an experience you have lived through together.
Getting a new therapist then is not as simple as the professional transition involved when you get a new plasterer for example (I have just realised there are a hell of a lot of interior design analogies in here which I think is in reference to my love of 90’s TV show Changing Rooms. I miss Carol Smiley. Where did she go. She was so Smiley). No, instead of a new therapist coming in to help you in the house you had made earlier, it is like having to smash all of that “brain internal understanding relationship” stuff to the ground and having to start again. Once again you need to start passing them all the individual bricks they have never seen before, so you actually have a long time of simply building up enough of a rapport/understanding before you can get on with any of the serious stuff.

Like the end of any romantic relationship you find yourself wondering if you will ever find someone you will get on as well with or who will understand the way you work in the same way, and the first sessions with a new therapist are very much like all the first dates you have to go on to try and find a new partner. Conversations go from deep personal investigations into the meaning of life to the cookie cutter “so what is your job”, “where do you live” standard statements that you have to go through before you can get to anything of real interest or value.
Unlike a first date of course, a new therapist will probably have all of your notes from the previous one and thus a rough knowledge of your history, but nevertheless, with or without these notes they will always say that they want to hear about your history “from you”. Admittedly this is a good idea. Obviously I can explain something that happened to me when I was eleven better than a therapist was able to jot down in a word document, but having to go through all that stuff is exhausting. Maybe if you don’t have a huge mental health history this “tell me about you” question can be answered relatively quickly, yet for me it is a question that is incredibly daunting. Tell me about your experiences with mental health services?! How can I do that? We have nearly 14 years of appointments to catch up on! I can’t get through all that in one hour!? DO YOU HAVE ANY IDEA HOW EXPENSIVE HOSPITAL PARKING IS?

This entire blog is probably just one long incoherent ramble so half of you reading will be probably wondering what the hell I am talking about and who the hell Carol Smiley is. I guess I just wanted to raise some awareness of how difficult it is when a member of your therapy team has to change and why it feels so much more impactful than a change in any other strictly professional relationship. If I was ruler of the world I think I would probably make it law that therapists are unable to ever get new jobs, retire, change jobs or go on maternity leave (sounds ridiculous I know but in terms of fair/rational leadership I would still be doing a better job than Donald Trump.)
Luckily as you will know if you have been around my blog for a while, I do have a whole team of therapists so it isn’t a total break down of my psychological support and only one person is changing. I also know and like the replacement very much so it is as “good” and manageable a “break up” as it can be. Nevertheless I can’t help but feel as though in a few weeks when it is time for our last session (on the 21st of March, put that in your diary folks), I will be losing someone very important, someone who I can trust and rely on, so naturally, this isn’t going to be easy.

Take care everyone x

therapistchange

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17 thoughts on “The Difficulty Of Losing A Therapist

    • You are still on the waiting list? God that is awful, I really hope they find someone soon and that you get the support you truly deserve. Remember I am always here if you need! Sending much love your way. Thank you for being my friend xxxx

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      • Yes, still waiting, it’s ridiculous!! Fortunately I have a sort of therapy guy at uni I can talk to, but he’s not an ED one so he just listens while I talk at him 😉 Thank you for being my friend too, and if you ever need me, I’m here anytime, always! Lots of penguin love 🙂 Xxxx

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  1. Oh I SO understand, Katie!! It is hard. I saw my old therapist in California from 2002 to 2015 and my old psychiatrist from 2001 to 2015. I also had a great doctor I had been seeing regularly for a few years. These people were my biggest supporters for years and I had to leave them all when I packed up and moved 2000 miles away. Yes, I left them, but I didn’t *want* to. I felt like I had no choice but to move due to various life circumstances. It was so, so hard! Then I went through so many different people after moving back here, trying to find good support, and it was failure after failure. I let go of some, some let go of me. It was crappy every time. It’s no fun to start over, especially when you have such a long history.

    So, I’m glad you still have other people on your team and hopefully they’ll be helpful during this transition. I totally get that it’s hard. It’s a loss, for certain.

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    • Gosh I am sorry that was your experience. I think I should count myself lucky that I at least have a good replacement all lined up! If you ever need to share her feel free to fly to the UK and I will book you an appointment 😛 xxx

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  2. Amazing post Katie!!! Unfortunately I can relate to this 😦 my old therapist was awesome and she really helped me. But it’s ok because my new therapist is very good too.
    Hope you’re doing fine lovely 🙂
    Kisses from Portugal ❤

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    • Yay! I am glad to hear that you also had a good replacement lined up just as I do. In fact I hope your new one is even better and helps you make more progress than you ever imagined possible! Hope you are having a good day, kisses from England ❤ xxx

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  3. Oh Katie, so many people will be able to relate to this post and empathise with your situation. When one of the few therapists I ever managed to connect with left the service, I felt almost as if I was bereaved. There was a definite sense of loss and of course much anxiety over my new therapist and what they would be like, whether we would be able to connect etc. I guess one positive thing you can take from it is that the fact you’re so upset about your current therapist leaving just shows what a good job s/he has done with you. You are lucky to have had him/her in your life, albeit for a shorter amount of time than you would have liked – many people go through countless therapists without being able to connect with one. In any case, all therapeutic relationships must come to an end at some point, whether naturally when you finish treatment or abruptly when they leave. Whatever your therapist has taught you will stay with you and although they may not be physically present for you to see and talk to anymore, they have taught you things and given you tools that you can remember and use forever xx

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    • Thank you so much. It is nice to hear a positive in this experience for once as all I have been able to think about so far is how horrible this all feels! Maybe I will make a notebook filled with all the things she has taught me over the years to cement our relationship in my memory and keep it as a positive piece of my past rather than a loss. Don’t cry because it’s over smile because it happened and all that! Hope you are having a good day my wonderful friend of loveliness and wisdom xxxxx

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  4. Omg I’m so sorry. I can’t imagine what I would do without my current therapist :(. I’m super scared to lose her. Because in my country you don’t have a team to help you with your mental illness, you just have to find someone who you can trust and it’s super difficult for me to trust someone. Great post as always 🙂

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    • Aww thank you, I will keep my fingers crossed that your therapist doesn’t go anywhere! It is so great to find people you can really talk to! Am really glad to hear you have someone you are able to trust though, I hope she helps you in your journey 😊 thank you for being lovely, always here if you need ❤

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  5. Thank you for writing this! My therapist left me so suddenley, and I have so much struggles with conecting with my new therapist. I really needed to read something like this, thank you. X

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    • Urgh that sucks! I strongly believe therapists should have to give a lot of warning before going anywhere. I hope things get better with your new one very soon! In the mean time please know I am always here if you need any support! I will be thinking of you 😊 xx

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