In October's installment of her monthly mental health column, writer and author, Beth McColl, discusses when to break up with your therapist and why sometimes, it's totally necessary. Beth is the author of 'How to Come Alive Again' which is a relatable and honest practical guide for anyone who has a mental illness. She's also very, very funny on Twitter.
My therapist and I almost broke up last week. It wasn’t dramatic or tearful or awkward, like an actual break-up chat might be. It was just a frank conversation between two adults. She asked if I was getting enough out of therapy, if I wanted to continue, and if so what I would like to change about how we worked together.
This discussion was prompted by a string of frustrating sessions, where I was quieter than usual, watching the clock, searching for things to say, and finding nothing. After almost a year of feeling confident with our progress, I was suddenly disillusioned by the whole process, skeptical of the idea that talking freely about my personal history might do anything besides stirring up painful memories. I thought of all the other things I could be doing with that hour instead, what I could buy with the money I was spending to sit dodging questions. I could have gone on several mini-breaks. I could have bought a Vespa and crashed it almost immediately. But instead of feigning a headache or a Wi-Fi emergency, I did the thing I least wanted to do - I told her exactly how I was feeling.
I should add here that my experience with therapy in the past hasn’t been particularly positive. I’ve had therapists share inappropriately about their own lives, consistently confuse me with other clients and dismiss my genuine concerns about the process. One therapist told me in our second session that what I believed was anxiety was actually past life trauma and that all of my depression was simply repressed anger at my father, who I had yet to mention. Another called me Kelly and spoke at length about her own ongoing divorce. In these instances, I didn’t bring up my concerns before making my decision to end things. I either sent a concise email or just stopped replying to their messages. Though I don’t regret this, I do wish I’d had a better sense of what I was allowed to ask for and the confidence to communicate more directly. Is there a ‘best practice’ for dumping your therapist? What do we owe to them, and ourselves, at that point?
I spoke about this to Dr. Jessica Tutino, a clinical psychologist working in Montreal. She stressed the importance of speaking candidly and openly where possible. “A strong therapeutic alliance is fundamental for creating a sense of safety and change, but just as not everybody is well matched to be friends or romantic partners, not all therapists are well-matched with their clients.” In other words, a therapist doesn’t have to be a ‘bad therapist’ or a bad person to be a bad therapist for you specifically. It may be that their methods don’t work or that their experience doesn’t align with your needs or your diagnosis. It may be that the chemistry is off, that you’ve gotten all you can from them or that they remind you of your least favourite dinner lady from Primary School. It’s not shallow to bail on your therapist simply because of a personality clash or a persistent bad vibe. When it comes to the relationship between you and a mental health professional, trust is vital.
But there are real benefits to speaking up directly instead of just vanishing. As Dr. Tutino explained, "your therapist [may be] able to refer you to another therapist who will be a better fit, or facilitate access to other resources". As with any break-up, your therapist may also gently suggest you rethink your decision, or provide reasons to stick with them. “People often feel worse in therapy before they feel better… That’s why I think it’s critical for therapists to be transparent with their clients about what to expect during the process of therapy and to provide direct feedback with their clients when they notice avoidant patterns, e.g. missing sessions… expressing a desire to stop therapy during a very difficult period”.
Sometimes, though, there’s a very valid case to be made for ghosting, or for ending things by email and not agreeing to a therapist’s request for a final meeting. I spoke to 25-year-old *Dilys who took painstaking steps in her early twenties to find a therapist who understood how to work with Autistic people: “Even though [the therapist] claimed to be sensitive and well trained in dealing with neurodiversity, from the very start it felt wrong. She never asked about my particular needs or preferences, rushed me when I was taking some time to process questions, and scolded me for using my stim toys when we met. I haven’t been back to therapy since.”
34-year-old *Martine also felt disrespected by a therapist, who was consistently late to their Zoom sessions, sometimes not turning up at all. “It got to the point where I was making excuses for this person that I was paying to help me, who was disrespecting my time again and again. Eventually, I just stopped paying her and looked for someone else.”
Sincere suggestions that everyone should ‘go to therapy’ frequently appear online and as well-meaning as they are, they ignore the fact that therapists are not a magical, benevolent group exempt from holding prejudice or doing harm. While seeking a therapist in the aftermath of a sexual assault, *Francis (31) struggled to find someone who was affordable, qualified to help, and LGBTQ+ friendly. They found themselves consistently misgendered or disrespected and eventually gave up. “The idea that therapy is for everyone is a privileged one,” they told me. “It should be, obviously. But so many therapists are from these privileged groups and that alone can make it hard to find anyone who really, properly gets what it’s like to be poor or disabled or non-white or an immigrant or disenfranchised or whatever, all of which are huge contributors to bad mental health anyway.”
With mental healthcare as widely underfunded and over-extended as it is, many of us are left navigating the system alone, encouraged to automatically trust the professionals while so often being given concrete reasons not to. And seeing the wrong therapist can be worse than a waste of time or money, it can actually do real damage. Contrary to what a lot of people online seem to think, therapy isn’t for everyone- both in terms of accessibility and helpfulness. It’s not a panacea for all emotional pain, and it doesn’t operate separately from existing inequalities and social ills. My own bad experiences soured my opinion of therapy for years, and it was only in the last year that I felt strong enough to give it another go.
The conversation with my therapist helped to clarify my feelings. Bringing it up gave her a chance to make adjustments to her approach, and offered me the opportunity to demonstrate my improved ability to clearly communicate my needs. For now, we’re good. But it’s important as recipients of therapy to remember that it’s okay to speak up or to end our sessions if they feel consistently draining or triggering, if we feel disrespected, or simply if we want to try a different approach. More than okay, in fact- it’s pretty f*cking therapeutic.
This was originally published on Glamour UK.