When Your Therapist Goes On Vacation

photomontage representing the idea of departure

Summer is in full swing and the month of August is about to roll around. In New York City, where I live and work, this means that many therapists seem to flee the city for the entire month.

It is not unusual to have an emotional reaction when your therapist goes out of town and therapy needs to take a break. There are people who don’t seem to be bothered much, but many people feel abandoned by the therapist. Others feel left behind and resentful, frustrated, angry or even enraged. Often, the level of anxiety rises and some people think to themselves, “Why does it have to be now?" or "How am I supposed to get through this?” One person put it this way: ”I imagine that you are going away somewhere wonderful with your loved ones and are enjoying yourself, while I have to stay behind with my problems and am struggling. I am so jealous.” These very understandable emotional reactions can make some people feel quite vulnerable and uncomfortable. Many times, those reactions are also followed by a feeling of embarrassment, and some surprise or even resentment that the therapist has become so important. In working with people who are struggling with a tendency to engage in self-destructive behaviors, I noticed that it is common for these self-destructive urges to spike around the time the therapist goes away.

If you are concerned about your therapist going on vacation, I recommend that you discuss your emotions and reactions with your therapist. It helps to talk about your feelings, and it is good to be prepared. Here are a few suggestions that can help in dealing with your therapists’ vacation:

• Ask your therapist to let you know when they go away, and ask them how long they will be out of town for. Discuss your feelings and concerns - these discussions can contribute a great deal to a helpful therapy process and can provide useful insights for your work together.

• Ask your therapist about coverage – what are their provisions? Will they be covering their own practice, that is, will they check and respond to voicemail? Are they available on the phone or through email? Will there be another therapist covering their practice? Talk about the pros and cons of seeing a covering therapist, and how you would go about scheduling an appointment. How would you feel about reaching out? Under what circumstances would you contact your therapist or the covering therapist?

• Think about and talk with your therapist about what situations might come up for you that could be stressful. What events, conflicts, or feelings may come up that you would have a hard time with? Talk about healthy coping strategies. What has worked in the past? What could you do to cope successfully? Prepare yourself.

• If self-destructive urges are an issue, discuss them with your therapist. Talk about what feelings, situations, people, or places might trigger those urges, and talk about healthy ways of dealing with these triggers. Try to anticipate what may be ahead. Devise an emergency plan with your therapist, and talk about where you can go, who you can reach out to, and about what skills you can use just in case. Commit to this plan, and to keeping yourself safe.

I hope you found this information validating, helpful, and reassuring. I also hope you have an enjoyable, but most importantly, a safe summer.

Simone Hoermann, Ph.D., is a Psychologist in private practice in New York City. She specializes in providing psychotherapy for Personality Disorders, Anxiety, and Depression. She is a faculty member of Columbia University, and facilitates psychotherapy and skills training groups at the Columbia East 60th Street Day Treatment Program.

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I forgot to mention that I tend to get "worse" when my therapist goes away. I'm not sure if there is any connection or not. Things start off great, and then by week two things start to go downhill. (I have an eating disorder). I'd like to think that is has nothing to do with her being away, that I'd still be doing the same things if she was around, but I don't know. I start to weigh myself more, restrict more, and just generally obsess more.

On a side note, I'm interested in reading your eating disorder article, but it is not coming up. It's just showing a blank page.

My therapist goes away for a few weeks every summer. I try to convince myself that this will also be a "vacation" for me, but that might not be the best way to look at it. I take a break from thinking and possibly working on the things I should be working on. I guess I "shut down" a bit.

She always has someone covering for her, but I would never call the covering person. I think it would just be weird. Even if I was freaking out about something, I don't think I call. To me, it's just weird to make an appointment with someone who knows nothing about you and just go in and start talking. The covering therapist has no idea what's going on in your life, who you are as a person, what your personality is, etc., so how can it really be helpful to go talk to a random therapist??