When is a good time end or pause therapy?

While we often discuss starting therapy, it is rare to see therapists discuss when to end psychotherapy. Since I started as a mental health counselor in Oregon, and worked with several clients, I have been thinking about this question more deeply. While premature termination from mental health counseling can be harmful for you, and leave you feeling exposed and vulnerable, too much therapy for too long can also be somewhat detrimental. I say this for three specific reasons

1. Dependency: The word dependency can draw up some unhelpful and dysfunctional images but I want to normalize and say that it is okay to feel dependent on your therapist or a helper once in a while. For instance, when I break my arm, I am likely dependent on my doctor to tell me what to do to care and heal myself. However, if we are in therapy for too long, chances are that we may start leaning a bit too much on our therapist to help us solve our everyday, surface-level challenges. I notice that when I reach an organic end to deep mental health work, some of my clients start bringing in surface-level challenges to therapy to discuss and process (e.g., last year a client wanted to discuss how he missed the sale price for a printer for the entirety of the session). It is not to say that these challenges are not important. But I believe that my clients can genuinely resolve these kinds of problems on their own, and are resourceful enough that they don’t need my therapeutic expertise. I would hate to be the therapist who doesn’t trust her clients’ inner resources and resilience.
2. Avoidance: It is common to hold on to therapy as an anchor point, something that stabilizes your week while other important components seem to be in a state of chaos. So many of us can use therapy as a way to organize our weeks, and feel grounded. While this is perfectly fine on some occasions, having therapy as your space to avoid looking deeply into other areas of your life can be counter-productive. I recall working with one client in Oklahoma. He was coming for weekly counseling sessions for over 3 years, to decide whether he should cut off ties with his father who was very abusive. My clinical instinct told me that at some point he had decided what he wanted in the relationship with his father, but was hoping to avoid acting on it by coming to therapy and discussing the minute details of how to have the conversation with his father. Remember, while we as therapists help you lead deep and meaningful lives, your real life is outside of these 50 minutes, in genuine and mutual relationships. Therapy cannot replace your life outside.
3. Fear: A sad reality I face repeatedly in my work is fear. Many of us are deeply fearful of the unknown. Having been in therapy for a long time, we may be unable to imagine what life would be like without the regular support of a therapist. I want to acknowledge that your fear is valid and genuine. It is okay to normalize this, and accept your fear of leaving or pausing therapy. We may desperately want to hold on to the known aspects of therapy, and the safety net it offers.

What should we do when notice ourselves in one or more of these categories? You can begin by validating and accepting your feelings and reactions to the idea of pausing or ending therapy. Journal or talk to a friend about what therapy has meant for you, and how challenging it may be for you to step away from it, even for a few months. It can be very helpful to discuss this with your therapist. While we spend many hours trying to support you, we are never going to be able to read all your thoughts. Direct and respectful communication about your experiences can help counselors plan for your treatment accordingly. When my clients bring these conversations up, I usually suggest that we start reducing the frequency of the sessions, and check how it impacts the client. If the change feels too much and/or too sudden for the client, we go back to the typical rhythm. If it feels sustainable, we steadily reduce the frequency until termination of services.

As with any good relationships, it is okay, and important to know when to walk away or when to pause. Therapy can be a helpful space to practice those skills. If a break in therapy feels appropriate it. It is often a sign of growth, and celebration of all that you have achieved so far! 

If this topic interested you, reach out to me at info@soulfulnesscounseling.com. I would love to know more about your experiences!