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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Twinleaf on December 29, 2011, at 23:48:19
I never thought that I would think about ending, much less write about it here. But, with lots of extreme ups and downs (see thread just above), I have been realizing that I have gotten what I wanted from therapy (psychoanalysis in a face-to-face style)- I got him. Not completely, not as much as I want, but I do feel very different. It feels as though his face and voice are in my mind, consciously, and other aspects of him - his range of feelings, his humor, a sense of his body and a deep sense of his caring are in there just below consciousness. SO different from before.
I haven't dared to tell him this yet; I'm just telling you! I imagine the best way would be to cut down the frequency quite gradually. As to really ending altogether - maybe not. At least until he retires. (in 12 years, he'll be 80 - average retirement age for analysts where I live)
What do you think is best? Do you get more of a sense of well-being and completeness if you terminate altogether, or is having some ongoing contact better and more supportive?
Posted by SLS on December 30, 2011, at 7:25:32
In reply to Thinking about.........termination......., posted by Twinleaf on December 29, 2011, at 23:48:19
> What do you think is best? Do you get more of a sense of well-being and completeness if you terminate altogether, or is having some ongoing contact better and more supportive?
Termination can be a process that takes several visits. That's how I terminated with my last therapist.
Good luck.
- Scott
Posted by pegasus on December 30, 2011, at 8:05:50
In reply to Thinking about.........termination......., posted by Twinleaf on December 29, 2011, at 23:48:19
For what it's worth, I can't imagine ending altogether, even over several sessions. My next ending is going to be so gradual that it takes at least a couple of years of tapering down. And then occasional contact after that . . . forever. Or until one of us dies. At least, if I have anything to say about it. Which I don't expect to. But my T insists that I will.
Sorry, I'm making this all about me. But it's fantastic that you are at a point where you can even consider this. I'm so happy for you. What are your thoughts about bringing this up with him? Are you afraid to hear what he thinks would be the best way to do it for you? I like your instinct to think it through for yourself before you take it to him. I know that in your shoes, I'd put too much weight on his opinion, unless I had already thought it through for myself.
Good luck, and let us know how your thinking develops around this.
- peg
Posted by Twinleaf on December 30, 2011, at 9:01:15
In reply to Re: Thinking about.........termination......., posted by pegasus on December 30, 2011, at 8:05:50
Actually, what I had in mind was a two-year period of gradually decreasing visits, with occasional visits after that. I don't want to do it in a way that causes a lot of stress or sadness, because that would be like the first abandonment. He has actually said that he thinks I will "do best" if I can have some contact indefinitely.
He is away for the holidays now, but I plan on talking about it in January. He may say that it's too soon! Thanks so much for your thoughts, Scott and Peg - I'll let you know what happens.
Posted by emmanuel98 on December 30, 2011, at 19:17:16
In reply to Thinking about.........termination......., posted by Twinleaf on December 29, 2011, at 23:48:19
My p-doc suggested we cut back to every other week for 4-5 months, then reevaluate, perhaps if I was okay go to once a month, but I felt that it was going to be painful however we did it and suggested we terminate and set an end date. I wasn't complete termination, since I was still going to see him for meds every 2-3 months.
As it turned out, ending abruptly like that was more painful than I had imagined. I tried but couldn't stick with it. After six months, I begged to start seeing him again. We are now down to every other week. I see another therapist -- DBT trained -- and he and she both felt she should be my primary therapist if I were in crisis again.
I keep feeling like I should cut back with my p-doc to every month, but I get upset thinking about it. He and my social worker both say why cut back? If I need him, I need him. It's okay. But I feel guilty about needing him still after 7 years. And he is 72 and will probably retire, though he says he has no immediate plans.
So just be forwarned that termination is painful. Maybe you will be better at it than I was.
Posted by Twinleaf on December 30, 2011, at 20:31:34
In reply to Re: Thinking about.........termination......., posted by emmanuel98 on December 30, 2011, at 19:17:16
Thanks, Emmanuel. I am very shaky about abandonment ( because of my mother's hospitalization after my birth), so I have to do it very gradually.,I give my analyst a huge amount of credit that I am even considering it!
Your doctor will probably always be very important to you, and why not? If you need him, it's wonderful that he's there. Your DBT therapist seems to play more of an educational role - if she's helping make the depressive episodes shorter, that is just wonderful. It's not always easy to find just what you really need, but it sounds as though you have!
Posted by Dinah on December 31, 2011, at 11:52:43
In reply to Thinking about.........termination......., posted by Twinleaf on December 29, 2011, at 23:48:19
I think it's great that you're having these thoughts while you are in a good place with your therapist. Do you think thoughts of his age might be encouraging you to be independent?
Are you actually using the "T" word? Even when I am most confident in my ability to do without my therapist, whether I'm bored or angry, I can't use the "T" word. What an awful choice of words. It conjures up annihilation and death.
It's totally understandable why analysts considered termination an essential part of the analytic process. Saying goodbye forever to a parental figure is terrifying. Certainly if one can get through that, one could consider oneself thoroughly analyzed.
I'm glad we live in a different time.
I think I'll just consider myself currently without any scheduled appointments. Until he dies, I'll think of my therapist as my therapist. And I'll think that I can pick up the phone and make an appointment whenever I need one. I just won't need one at the moment.
I'm no good at goodbyes. With my father and with a few of my dogs, I make sure I think of them every day so that I won't lose the sense of their presence even though they're dead.
So, I suppose I'm saying I'd be inclined to just space my appointments further apart over time, to the point where I might not have one currently scheduled.
I'm *not* thoroughly analzyed.
Posted by Twinleaf on January 1, 2012, at 10:15:46
In reply to Re: Thinking about.........termination....... » Twinleaf, posted by Dinah on December 31, 2011, at 11:52:43
Who is? Not me, certainly! I still get very easily upset and depressed, although I have had a lot of good times in the year just past. It's mostly just a feeling of having what I need inside me, rather than outside me, so that I have to be with him in his office to get what I need.
He's 68, and just had a health scare about bladder cancer ( turned out to be stones), so you are right: there is a practical aspect to all of this. But I do think that I have partially internalized him. If I hadn't, I would be fighting to see him, without regard for illness or the passage of time. I wonder why I was able to accomplish this with him, and not at all with the previous analyst. The real reasons are probably beneath consciousness.
Posted by Dinah on January 4, 2012, at 9:32:30
In reply to Re: Thinking about.........termination....... » Dinah, posted by Twinleaf on January 1, 2012, at 10:15:46
Well, your previous analyst didn't seem to be keeping the sort of therapeutic neutrality (in the best sense of the word) that is needed for a client to move past the most intense feelings.
Also, I think there's chemistry involved that isn't easily explained. If you were to describe my therapist to me, I might not be all that impressed. But somehow his combination of intervention and non-intervention was what I needed. A more or a less active therapist might not have been as effective, given my combination of contrariness, distrust, and dependency. And however much I might learn about his personal lack of dependable stability, he projects a solid safety in session. Usually.
My therapist jokes that the T in my mind is far better than he is. So I guess I've learned to internalize as well.
I'm perhaps projecting a bit. When the health care changes go into effect, and contributions to flexible spending plans decrease to a third of what they are now, therapy is going to get far more expensive for me. I think, in part, my drawing away is related to that.
Posted by Wittgensteinz on January 8, 2012, at 11:07:46
In reply to Re: Thinking about.........termination....... » Dinah, posted by Twinleaf on January 1, 2012, at 10:15:46
Twinleaf,
I can relate to this. Firstly, thinking about terminating and then the next step of acknowledging those thoughts in front of the therapist - I remember such a session some months ago. My heart was racing and I felt panicked even though it was just my telling him that the thought had been on my mind, not that there were definite plans of some kind. Furthermore, like you, I have a therapist who is older - mine is 72 and I has told me that he plans to continue until 75. I am welcome to continue seeing him until he retires (I suspect he expects I will, but we'll see - I'm considering moving 2+hrs away next September which would make my visits practically speaking a little difficult). In some ways I'd rather leave than be forced to leave, if you know what I mean. In my case, contact after 'the ending' (like Dinah, I also don't much like the word termination - it makes me think of an unwanted pregnancy!) is expected - my therapist has said to me that he'd like to know what happens to me - to keep in touch - he hopes I will write (and presumably he will then write back) and visit on occasion - I'd also find this helpful and easier than simply cutting off contact, never to see or hear of him again.
In my case, I have already reduced my sessions to once a week. I wouldn't really want to reduce them further and nor would he - this works fine for me, although I grieved to begin with (it took about a year before I got completely used to having fewer sessions and still occasionally go for a second session if helpful).
It's great to read how well things are going and the extent to which you have internalized him. That must feel good. My advice with regard to broaching this subject is to take things gently - just allowing yourself to contemplate the idea is already a big thing, and when you are ready you can acknowledge this together with him and sit with it for as long as you want to before having to act on it in some way.
Witti
Posted by Dinah on January 9, 2012, at 11:34:30
In reply to Re: Thinking about.........termination....... » Twinleaf, posted by Wittgensteinz on January 8, 2012, at 11:07:46
I'm glad you're doing well with him!
I have so much trouble with continuity that I'm afraid of reducing sessions because I'm afraid that if I do, he won't be able to help me when I need him to. Does it feel the same, with reduced frequency?
Posted by Wittgensteinz on January 9, 2012, at 14:11:22
In reply to Re: Thinking about.........termination....... » Wittgensteinz, posted by Dinah on January 9, 2012, at 11:34:30
Do you mean that you're afraid you'll lose the connection needed in order for him to help you when you need him to?
To begin with it didn't feel the same and really it took quite a while before I adjusted. It spilled over into my daily life too - I found myself forgetting things/losing things during the first weeks after the reduction in sessions. This didn't last however, I gradually adapted and things feel the same - obviously the relationship changes over time in any case but the reduction in intensity hasn't interfered with that. I've always been able to schedule extra sessions should I want/need them, so in that sense when I've needed extra contact it's been there - that in itself is very reassuring even though I rarely go for extra sessions. The one time when it does hit me though is just before a break and just after - it's harder to get started again/back into the swing of things with just one session a week.
I'd say it's good to be in a good place if/when you reduce sessions and to talk it through a lot first - then if you decide to do it, do it on a trial basis so you don't feel pressured to keep with it should it not suit. There's nothing final about it - if you feel you can't maintain the connection/closeness then you can always notch the frequency up again. It may just not be the right time and these things can't be rushed.
Witti
Posted by Dinah on January 10, 2012, at 9:17:52
In reply to Re: Thinking about.........termination......., posted by Wittgensteinz on January 9, 2012, at 14:11:22
I'm so pleased for you, Witti. It sounds as if you're adjusting very well.
Because of the holidays, etc. I've only been seeing mine once a week. I haven't been able to maintain the connection. :(
My life is too choppy.
It's great to see you, on top of the treat of seeing Twinleaf again!
Posted by Twinleaf on January 10, 2012, at 11:00:05
In reply to Re: Thinking about.........termination....... » Dinah, posted by Twinleaf on January 1, 2012, at 10:15:46
Aw, thank you, Dinah - those feelings definitely go both ways. I can remember you and Witti ( and me) posting years ago when we were really struggling to get connected with our T's. Looks like we are succeeding in our differing ways.
Today, mine left to go to the APSA meetings in New York. He is leading a seminar there. He said something about not wanting to cause any rupture between us . Without knowing I was going to say this, I said, "I don't think anything can now." he gave me the most heartfelt look and smile ever.
Such a happy moment - haven't mentioned anything about endings as yet.
Posted by Wittgensteinz on January 10, 2012, at 20:07:28
In reply to Re: Thinking about.........termination....... » Wittgensteinz, posted by Dinah on January 10, 2012, at 9:17:52
Thanks, Dinah - I know I haven't posted in a long while and probably I'll come and go as I usually do.
I'm sorry life has been turbulent for you and that the connection isn't possible with once-a-week sessions. It must be hard for you at the moment. When will you return to 2 sessions a week?
My life has also been a bit turbulent but in a different way - psychologically I'm the strongest I've been in a long while, but unfortunately have had some unexpected health problems and as a result had major surgery a few weeks ago, a week in hospital and about a zillion hospital appointments.
For someone who didn't much want to live a few years back, being confronted with my own mortality has made me realise how much I do want to live now. And now the hospital drama is hopefully over with for a while at least, I feel like doing things I'd never dreamed I'd want to do before - quite strange really! I've also discovered to my surprise that I might just be an optimist after all.
Witti
Posted by Wittgensteinz on January 10, 2012, at 20:19:06
In reply to Re: Thinking about.........termination......., posted by Twinleaf on January 10, 2012, at 11:00:05
Wow, that sounds like a magic interaction and so spontaneous.
I hope that feeling continues during his absence. I know it always helps me when the session before a pause goes well - it leaves a lovely warm feeling which carries you through.
I remember when you had just started seeing your current T. - he's the T. who has a chess board in his office, right? In a way time has flown by - it's nearly 5 years now since I joined babble and started therapy. A lot of critical moments in the process have been recorded here - and the same goes for both of you. Maybe one day I'll take the time to go back over it all to reflect a little bit.
This is all very positive - it's very nice to see when people really grow from their experience of therapy - where the therapeutic process over time instigates fundamental growth and change.
Witti
Posted by antigua3 on February 12, 2012, at 20:41:20
In reply to Thinking about.........termination......., posted by Twinleaf on December 29, 2011, at 23:48:19
Twinleaf,
i wanted to just write and let you know hard and wonderful it is to go through termination. I terminated with my T in the best wonderful possible, knowing that it was time and that i could still call her, and now with my psychiatrist. It's time and i think things are are good as they are going to get, which is pretty good.What I want to say is that look into your soul and check to see if you are doing this because it's the right thing, or if you are running. I only say this because many times my supposed termination is more about running from the tough things I needed to face now that I had the relationship with my psychiatrist that took so very long to achieve.
Now that we have that relationship, I think it's time to terminate, and I am doing it slowly, knowing that i am dealing with the whole aspect of termination and what that means to someone who was abandoned repeatedly. But as we edge toward termination, I discover that the strength of our relationship is allowing a freedom of spirit to come out that wouldn't have been possible before, and that takes me places never thought possible.
In any case, sounds like you are in a great place. My only advice (and you didn't ask for it) is to take the termination as seriously as you have taken your therapy. Know what the ground rules will be so that you are armed, prepared and ready.
All my best,
antigua
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