Am I Done Yet?
Someone recently asked me how one would know when they are done with therapy. Well, as I tell my clients when they ask me about this,
"Your therapy is done when my student loans are paid off. Stop asking dumb questions, that's why no one loves you."
Okay, so maybe I DON'T say that to anyone.
Most clients come to therapy because, in a general sense, there is something wrong that they don't like, and they want there to stop being something wrong. This could be problems they see within themselves, or problems they see with others (sure, because I can change people who aren't there in the room with me, right?). Sometimes they are ambivalent about change, but ambivalence is simply feeling two ways about something (in this case, both wanting to make changes and wanting to stay the same - what is the same is familiar and comfortable, even when it feels bad). Either way, the client is often emotionally unhappy, confused, or disconnected. Depending on the client's issue and the therapist's perspective, it could be understood as relational, cognitive, behavioral, skills-deficit, self-image, confidence, difficulty making choices, and/or inability to capitalize on their strengths. A therapist works with the client's view of the problem to help them to gain insight into it and what they might do about it.
In short, and to quote one of the premiere philosophers of the early 1990's, "If you got a problem, yo, I'll solve it."
When you, as the client, begin therapy feeling motivated and/or interested in addressing some issues (and "the issue" to be addressed often changes over the course of treatment), there are a couple of ways to notice when you are getting done with therapy. Perhaps foremost, when your motivation to attend therapy sessions begins to decline and you start to wonder whether you are done with therapy, that is often a good sign. This can indicate that therapy is not as much a priority, or that it is not as important/necessary/ or useful to you. Be careful, though, because people sometimes have trouble addressing deeper issues, and as a result can start to withdraw from therapy. I think that a useful distinguishing feature is whether or not your therapist is encouraging you to consider issues which you do not think you have; if this is the case, you may be in denial, whereas if your therapist does not seem to be encouraging you to address something else, denial is less likely. However, sometimes therapists, whether by error (we all make them) or due to inadequate training, can be mistaken about a problem. Still, most therapists can have a mistaken idea, but be willing and able to let go of it after exploring it or testing it out.
As a therapist, my goal is to become useless to my clients. When beginning therapy, clients often need more from me in terms of support, guidance, effort to "push" and challenge a bit toward difficult emotions/thoughts/experiences, patience, and helping to interpret deeper meanings and dynamics. One of my goals, and a really good sign to me that therapy is working, is when the client is not only (or not necessarily) feeling better emotionally, but also not needing me as much to do the work of therapy. Now, sometimes this takes longer than others; I have had clients who were done with therapy in as few as 1-3 sessions, others who ended after 10-15, and another who even after 11 months was still relying on me for support and was not yet ready to do it more "on her own." When you feel that therapy is less useful to you (and when it's not denial or avoidance of something difficult), this is another indicator that treatment might be winding down.
Related to this, if you used to have alot of "therapy material" to talk about with your therapist, but now find yourself mostly talking about "non-therapy material," maybe treatment is coming to an end. For example, a client of mine used to have alot of anger and insecurity (the two often co-occur) to talk about; now he's not having many problems with anger and insecurity, and he is spending much of our sessions talking about things like his father's new car, an interesting movie he recently saw, and other non-issue topics. When the conversations become more "social" than "therapy", it might be time to stop. However, it is also possible that this indicates another block and attempt to distract yourself and/or the therapist from something more difficult to address (I do not think this is the case with the client I used in the example).
Be aware, too, that there may be a difference between a problem/issue still remaining in some form and you still needing therapy. I have ended with clients who, although their life or emotional experiencing was not perfect, they had a good enough handle on it that they were able to manage it on their own; at the end, I had just been watching them do it without them needing much from me.
Always, always, always talk to your therapist about your perception that treatment seems to be drawing to a close. This will allow you to ascertain whether or not a professional sees your need for therapy (or lack thereof) in the same way that you do. It also prevents you from ending too soon. In addition, I see one of the benefits of the ending phase of a therapy relationship as giving the client the chance to say good-bye; this is not something that usually happens at the end of types of other relationships (whether due to death, break-up, falling-out, or drifting apart), and it can be a supremely powerful experience!
"Your therapy is done when my student loans are paid off. Stop asking dumb questions, that's why no one loves you."
Okay, so maybe I DON'T say that to anyone.
Most clients come to therapy because, in a general sense, there is something wrong that they don't like, and they want there to stop being something wrong. This could be problems they see within themselves, or problems they see with others (sure, because I can change people who aren't there in the room with me, right?). Sometimes they are ambivalent about change, but ambivalence is simply feeling two ways about something (in this case, both wanting to make changes and wanting to stay the same - what is the same is familiar and comfortable, even when it feels bad). Either way, the client is often emotionally unhappy, confused, or disconnected. Depending on the client's issue and the therapist's perspective, it could be understood as relational, cognitive, behavioral, skills-deficit, self-image, confidence, difficulty making choices, and/or inability to capitalize on their strengths. A therapist works with the client's view of the problem to help them to gain insight into it and what they might do about it.
In short, and to quote one of the premiere philosophers of the early 1990's, "If you got a problem, yo, I'll solve it."
When you, as the client, begin therapy feeling motivated and/or interested in addressing some issues (and "the issue" to be addressed often changes over the course of treatment), there are a couple of ways to notice when you are getting done with therapy. Perhaps foremost, when your motivation to attend therapy sessions begins to decline and you start to wonder whether you are done with therapy, that is often a good sign. This can indicate that therapy is not as much a priority, or that it is not as important/necessary/ or useful to you. Be careful, though, because people sometimes have trouble addressing deeper issues, and as a result can start to withdraw from therapy. I think that a useful distinguishing feature is whether or not your therapist is encouraging you to consider issues which you do not think you have; if this is the case, you may be in denial, whereas if your therapist does not seem to be encouraging you to address something else, denial is less likely. However, sometimes therapists, whether by error (we all make them) or due to inadequate training, can be mistaken about a problem. Still, most therapists can have a mistaken idea, but be willing and able to let go of it after exploring it or testing it out.
As a therapist, my goal is to become useless to my clients. When beginning therapy, clients often need more from me in terms of support, guidance, effort to "push" and challenge a bit toward difficult emotions/thoughts/experiences, patience, and helping to interpret deeper meanings and dynamics. One of my goals, and a really good sign to me that therapy is working, is when the client is not only (or not necessarily) feeling better emotionally, but also not needing me as much to do the work of therapy. Now, sometimes this takes longer than others; I have had clients who were done with therapy in as few as 1-3 sessions, others who ended after 10-15, and another who even after 11 months was still relying on me for support and was not yet ready to do it more "on her own." When you feel that therapy is less useful to you (and when it's not denial or avoidance of something difficult), this is another indicator that treatment might be winding down.
Related to this, if you used to have alot of "therapy material" to talk about with your therapist, but now find yourself mostly talking about "non-therapy material," maybe treatment is coming to an end. For example, a client of mine used to have alot of anger and insecurity (the two often co-occur) to talk about; now he's not having many problems with anger and insecurity, and he is spending much of our sessions talking about things like his father's new car, an interesting movie he recently saw, and other non-issue topics. When the conversations become more "social" than "therapy", it might be time to stop. However, it is also possible that this indicates another block and attempt to distract yourself and/or the therapist from something more difficult to address (I do not think this is the case with the client I used in the example).
Be aware, too, that there may be a difference between a problem/issue still remaining in some form and you still needing therapy. I have ended with clients who, although their life or emotional experiencing was not perfect, they had a good enough handle on it that they were able to manage it on their own; at the end, I had just been watching them do it without them needing much from me.
Always, always, always talk to your therapist about your perception that treatment seems to be drawing to a close. This will allow you to ascertain whether or not a professional sees your need for therapy (or lack thereof) in the same way that you do. It also prevents you from ending too soon. In addition, I see one of the benefits of the ending phase of a therapy relationship as giving the client the chance to say good-bye; this is not something that usually happens at the end of types of other relationships (whether due to death, break-up, falling-out, or drifting apart), and it can be a supremely powerful experience!
posted by CMA @ 8:29 PM
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