A reader emailed me this week to ask about "patients returning to therapy with the same therapist following termination. What concerns might the psychoanalytically oriented therapist have, both for and against the idea?"
At first I wasn't sure how to answer because patients returning is so commonplace in my life. In fact I worked with an analyst for a number of years, left for 6 years and then returned to work again with him.
Many patients leave when they have reached a place that leaving seems right for them or their circumstances improve and come back even years later to do more work. The work then is actually all of a piece spread out over a number of years, rather like chapters in a book. It is pretty routine when a patient leaves in these circumstances to let them know the door is open should they wish to return.
If the leave-taking is due to conflict, returning is still not out of the question. Both therapist and patient need to be willing to explore why the conflict occurred and how it might remain an issue in ongoing work. But much is available to be learned from working through these kinds of issues so that they exist is not necessarily a barrier. In my experience though, these patients are not likely to decide to return though.
As with most things in therapy, it is important to be willing to look at the meaning of returning and what the patient hopes for.