Therapist Emotions When Clients Terminate

I’ve seldom seen discussed in the literature how therapists deal with their feelings when clients terminate.  There are, of course, many types of termination.  One is where the therapy has been long-term and growthful and the therapist feels sadness, even grief, at the ending because the therapist has developed affection, even love toward the client.   In some ways, psychotherapy is one of the most intimate relationship a therapist can have.  It is, of course, a one-sided intimacy.    The client reveals himself or herself, hopefully with greater depth and self-disclosing, as the therapy proceeds.    While the therapist should not reciprocate with self-revealing content unless  it is an aid to the process of therapy,  the therapist’s empathic resonance with the client is, as much therapy research has shown,  necessary for the maturing and growth of the client.  The therapy is a journey therapist and client take together and, when long-term, involves therapist and client in an intense dialogical process as they traverse the client’s  many intense emotional experiences  together.

There are other types of termination, however,  that leave the therapist confused, even feeling hurt and inadequate by the way the client leaves.  For example,  the therapist thinks the therapy is going fine, likes the client and thinks the client likes the therapist, but the client suddenly decides to stop, either just not showing up for appointments, or suddenly announcing in person or over the phone that they are not continuing.   And not giving a reason.  Or the reason they give is not very genuine.  “I just want to take a break” is what I’ve heard from some clients through the years, with the “break” lasting forever!    A few years ago I read a study that was published in the Division 29 newsletter in which clients and therapists were given surveys to determine how each party was seeing the therapy.    The researchers found that when therapists and clients were surveyed, the former were very poor at judging correctly their clients’ assessment of how the therapy was proceeding. This study made me aware that, at times,  I probably wasn’t reading these clients’ dissatisfaction with how the therapy was progression.  I have since tried to assess on a regular basis how my clients are viewing their work with me.

I shall discuss in subsequent posts various types of termination: when the client and therapist cooperate on how termination is handled;  sudden, when the client dies; and sudden, when the termination seems premature to the therapist.    I shall also discuss various solutions I and other therapists have come up with to deal with their sadness, grief and feelings of failure when the termination seemed premature.  I welcome feedback to these postings.