Endings

Endings

At any given moment you have the power to say: This is not how the story is going to end. - Unknown

It is never too late to become what you might have been - George Elliot

Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending. - Carl Bard

One guarantee about therapy is that it will come to an end; nothing lasts for ever and that includes therapy. However, ending therapy is not necessarily something that will be easy. It can be accompanied by feelings of loss, anxiety or sadness, all of which are perfectly normal emotions when ending a relationship. What’s more, the end of therapy can trigger powerful feelings that relate to other times you have experienced loss, rejection or abandonment.

I had a good relationship with my therapist but found the ending very difficult, maybe because I had found the therapy helpful and didn’t want it to stop.

This can be an opportunity to work with your therapist to have a ‘good ending’ this time, and working through the feelings the ending brings up can leave you feeling stronger.

How and when it is appropriate to end therapy can depend upon the type and expected length of therapy. Therapy can be long term over many years, but many therapy services, particularly those provided by the NHS, offer time-limited therapy typically between 6 and 20 sessions. 

Whether entering into short or long term therapy, the ending should not come as a surprise. Your therapist will be aware that endings can be difficult so most experienced therapists will start talking about the end of therapy several sessions before the end is due. They may even broach the subject from the start. For example, with short term therapy, this could be at the very beginning, which may feel strange and uncomfortable but is a necessary part of structuring the therapy. Some therapists may draw up a contract. Addressing the end of therapy early on means that you have time to get used to the idea and that any anxiety or new problems that arise can be dealt with in the remaining therapy sessions.

So that you know when it is time to end therapy, it is important to have a clear structure set out at the beginning of therapy together with the goals you wish to achieve.  Once those goals have been achieved, it is likely to be time to end therapy. In short term therapy these goals will be linked to the amount of time you have available with the therapist. To ensure that you feel emotionally stable and able to cope when therapy ends, therapy should be structured in the same way as an individual therapy session with the deepest and most emotionally difficult things being addressed at the mid-point so that you are able to reach a place of safety and stability by the end. If this has not happened, it is imperative to discuss this with your therapist.

The thought of ending therapy may make you feel very anxious, but this doesn’t mean that it isn’t right. Feeling anxious about ending a relationship is a natural feeling. It is, however, important that you share your feelings about ending therapy with the therapist so that you have time to work through them.  Another emotion you may feel when ending therapy is a sense of loss – losing an important person with whom you feel you have become close. If this feeling is extremely painful it may be that the therapist has allowed you to become too close. A therapist is somebody who helps you deal with specific problems but is not the person who meets your emotional needs outside of the therapy room. It is their responsibility to make sure this does not happen. For this reason a therapist should work within certain professional ‘boundaries’ to ensure that the relationship between you is professional rather than personal.

The final sessions leading up to the therapy ending may be spent discussing how you are feeling about therapy ending, the progress made towards your goals, and the tools and techniques you have learned in therapy.  This will mean that you are more likely to be able to manage any future difficulties yourself without the help of the therapist.  Ending therapy could be regarded as a new beginning and a time of transition.

There may be times when you want to end therapy yourself before any agreed ending is due. This could be because you don’t feel that therapy is helping, you do not like the therapist, or you are finding it difficult to deal with the emotions thrown up by therapy. In all these cases, it is important that you try to speak to the therapist about any difficulties you are having so that you have the best chance of getting them resolved. A good therapist will not mind you doing this; in fact, they should encourage it. It may be that the difficulties you are having are expected and part of the process of therapy, (therapy can be stressful and difficult) so it is important that you talk this through. It can be difficult to talk about such things with your therapist so you might want to email them or write a letter. 

If you don’t feel that you can talk to the therapist, try to speak to somebody who can speak or act on your behalf, this could be a friend or relative, your GP, an advocacy service, or another professional, such as the head of the therapy service. It is within your rights to ask for another therapist if you do not feel safe or uncomfortable with them. Understandably, you may feel tempted to simply stop attending therapy sessions; however, if you do this there is a danger it could limit any chances of either resolving the difficulties or accessing a different therapy or therapist.  Some NHS therapy services operate a ‘stepped care’ system which means that if therapy isn’t working you can be referred to a different type or intensity of therapy; this would be more difficult for you to access if you stop attending therapy without warning.  Therefore, it is important to try and address the problems in some way rather than avoiding them.