A reader asked me to write about " termination.... when it's called for, what a good process looks like...how you know it's different from a break". Good questions and I'll do my best with them.
Termination is called for when the therapy has ended. That's the ideal -- when both therapist and patient feel that the work has been accomplished. In any kind of depth psychotherapy, it is hard to define when that time is and certainly it cannot realistically be set in advance, not in this kind of therapy. In the first session, it is not possible to know if this work will last 6 weeks, 6 months, 6 years or more. That all depends on how things unfold and how far the patient wants to go.
Maybe it helps to consider that therapy is a process, not a destination. It isn't like a graduate program with a diploma or certificate at the end. Because there is no defined end. The process begun in therapy optimally will continue for the rest of your life.
So, in a sense, therapy is over when you decide you've gone as far as you want to go. Cure is meaningless here -- what is it that would be cured? It helps to have in mind what you want from therapy, what it is about for you and to review that from time to time, with yourself and your therapist.
Now it is often the case the the urge to terminate comes when something difficult is in the offing. Why? Because it is human to want to avoid work that is difficult or painful. So if things have been going along productively in your therapy and you rather suddenly announce your desire to end, don't be surprised if your therapist asks why. Why now -- what makes you feel this way today but not last week or 3 weeks ago? What is going on?
Money is the most frequently cited reason for wanting to end. However if you ask these patients if they talked to the therapist about a fee reduction, they almost never have. When the patient and the therapist have a shared commitment to the work they are doing together, they can work out changes in fee to deal with changes in circumstances. It is useful to ask yourself if you are using money as the reason what else is making you want to leave. Because it is almost certainly that that "something else" is something that needs to be dealt with.
So when your therapist starts challenging you on your desire to end, be willing to explore this with her. She is not trying to keep you from leaving, but trying to help you make a good decision, whether it is to stay or to leave.
The termination process is not about trying to keep the patient from leaving. It may come up in the process that the therapist feels some important unresolved issues remain on the table. But we cannot compel anyone to stay so the choice to leave, the power to leave always rests with the patient. What we hope for always is a good ending, but we don't always get what we want.
Tomorrow, in Part 2, we'll look at taking a break in therapy and how that differs from termination.
And then in Part 3, we'll look at how to do a good ending.