The end of therapy

Books and articles on psychotherapy make a big deal of termination of therapy. The clinician should make a big deal of it. Clients need time to wrap their mind around ending this deep relationship, need time to review their gains, need time to gradually be set free to handle their life without the safety net of this drastic and intimate bond. Client and therapist talk about this process as it is happening over weeks and months, gradually weaning away to a poignant farewell.

Not in my world. I can say with certainty that most of my clients change in thought, insight and feeling, and therefore movement, as a result of our work. The great majority of them express appreciation. But there are very few terminations. Most of them fade away, stop coming in, no notice given, even those whose therapy casualized to friend and confidante over the course of a year or two. Just disappear. There is no reason for me to suspect that I am wrong about their benefits gained or their appreciation. But I know my work doesn't lead to happy positivity: more like sober or grave or blunt positivity. Clients may come to see they need to be hopeless about having loving parents. They may come to see that meaning in life happens in childhood – it is a healthy child's natural stimulation in the world – and that they will have to settle for different kinds of meaning. Evaporating their anger at their wives may come from finding and grieving their child-self and deploring or abhorring their father who shamed them. They may teeter on the edge – scissors trembling in their hand – of cutting the umbilical cord to a solipsistic miserable parent. That would leave them feeling, partly, homeless and selfless: a difficult state to consider "success" in therapy.

I can imagine that at a certain point, clients feel alone and go off on their own. That would be a paradox, as I'd tend to feel closer to them as time went on. They didn't have the positive-feeling bond with me because I helped them be their solo selves in a darker psychological world, not hoist themselves onto a platform of false feel-good, holding my hand, my glad-handed encouragements. That would leave them precarious, especially with a Cognitive therapy that produced a speciously warm relationship of thinker to thinker, not goad to feeling.

I'm sure, though, that some of them will be discomfited, those who want to live in their head while I've pointed them to the body, to the muck of their history. They will fade out, too.