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Graduating Therapy

Question:

I’m in therapy currently, and i have been for almost two years for depression/anxiety and borderline symptoms. I’m happy to say that I’m doing pretty good, and I’m supposed to “graduate” from therapy soon. Despite this recovery, I’m afraid I don’t trust myself to form solid relationships or to pursue ambitious plans yet. I’m terrified that one day I’ll relapse and hurt everyone around me again. Is this feeling normal, and what can I do to stop it?

This Disclaimer applies to the Answer Below
  • Dr. Dombeck responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
  • Dr. Dombeck intends his responses to provide general educational information to the readership of this website; answers should not be understood to be specific advice intended for any particular individual(s).
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Answer:

The feeling is not only normal, it is almost universal. Many people are fearful of entering into a therapy relationship at first, but once they become comfortable with the routines of it, therapy becomes a safe and nurturing place where you aren’t judged, where you’ll be understood (or at least someone will try to understand) and where you can relax a little, even while challenging yourself to grow. The gains people make in a therapy situation are gains they make themselves. The therapist is a guide and a comforting presence, but he or she doesn’t (and cannot) do the actual healing work; the therapy client/patient does that work. Nevertheless, when it comes time to depart from therapy, and especially when the therapy has gone on for a long while, clients/patients almost universally feel frightened by the prospect of having to go about their lives without the support of the therapist. Normal stuff. The thing to do is to talk about this upcoming departure with your therapist now and prepare for it. Another thing to do is to talk about a weaning schedule. If you’ve been going regularly on a weeky basis for a long while, try stepping it down to twice or once monthly, and then, when that feels comfortable, to an ‘as needed’ basis (e.g., a couple times a year). There need not be a definitive end to your therapy, even though you will hopefully have graduated to a different ‘stage’ of therapy. Leaving therapy need not be like being forced out of the nest with no return possible. If in fact you find that you do need to return to therapy on a more regular basis, well, that is fine too. It is a good thing to stand on your own when you are strong enough to do that well. However, no man is an island. When things become too delicate to handle and coping effectively becomes too challenging, the strongest and most intelligent thing you can do would be to seek out more regular help again.

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