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Re: When to End Therapy? Dx. PTSD Speaker

Posted by Dinah on January 1, 2004, at 13:50:58

In reply to When to End Therapy? Dx. PTSD, posted by Speaker on January 1, 2004, at 13:23:47

I have a few books devoted totally to terminating therapy, and also many books with chapters on it (that are the first things I read). And yet darned if I can tell you.

Do I recall that you do CBT therapy? I considered my CBT therapy complete when I could deal with my residual OCD thoughts and occasional panic attacks. I had klonopin as well. I consider my OCD to have been "cured" by CBT, even though I still have OCD thoughts and the occasional panic attacks because I can recognize the thoughts for what they are, and I deal with the panic attacks with breathing exercises and medication. I don't think they'll ever go away completely. They seem to be a way my body copes with stress.

If you feel like you're comfortable enough with your sypmtoms as they are, that you have them under control, that they don't cause enough distress that they interfere with your life, and that you'd rather have the time and money you currently use for therapy, the books I've read seem to indicate that you have a good case for termination. And nowadays termination is generally not final. If you have an upsurge in symptoms or a new life circumstance that you need help with, you can go back for a long or short booster.

The other alternative is to change your therapeutic focus. If you do CBT you could try EMDR or hypnosis. You could try a more psychodynamic approach. That's what I'm doing right now. I feel stuck a bit, and I'm not willing to lose my secure base by having my therapist change his style too much, so I am going to use EMDR as adjunctive therapy while having my therapist help me deal with the fallout (if any).

The personal experiences I've read where there is a "natural" ending to therapy seem to describe the client spending less time thinking of therapy between sessions and more time thinking about alternative uses of time and money. There might be anxiety at the thought of stopping but not terror.

I'm not sure there is a definitive answer...




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