I always thought there were implicit rules to the therapist-patient relationship: patient pays therapist to listen to her yammer on, therapist offers patient insight about her yammering…on and on until the patient runs out of reasons to yammer.
Six weeks ago, that understanding changed for me, in a rather radical way. Four words signaled the end: “We’re not making progress.”
Let me back up. I started seeing a therapist when I was 17, with an anodyne complaint of insomnia. But the insomnia led to a series of minor panics: If I didn’t sleep, I would be benched in my field hockey game. Or I’d fail my history test. Or my immune system would go on strike. It was a self-fulfilling prophecy, a feedback loop of rational and irrational fears. During exam week, I holed up in my dorm room with a box of protein bars and the poems of Horace and Catullus, emerging five days later happily emaciated, muttering verses from “Lesbia,” roaming campus like a madwoman.
My mother, bless her, determined I’d had a nervous breakdown. Professional intervention was required.
I saw Dr. Anderson for seven years. He was a family doctor; a mom and pop shrink from Massachusetts who typically stayed at his office until 10 p.m. He was affable and warm—more Mr. Rogers than Freud—with a refreshingly dry sense of humor, considering he spent most of his life earnestly talking people off ledges.
When I first moved to Manhattan, the relative ease of college left me unprepared for constant rejection in the real world (I had been passed over for enough editorial assistant jobs to consider taking hostages at Condé Nast). But from the quiet solitude of small-town New England, Dr. Anderson would offer a soothing late-night phone call or Skype session.
It was comforting, a temporary salve, but we both agreed I should see someone more regularly in New York. Ours was an amicable split, borne out of practical necessity. But I was still despondent, desperate to salvage every positive experience from a relationship that had run its course. I hoped we could be friends, maybe even Gchat from time to time.
And like an old flame from a previous era, Dr. Anderson (not his real name) recently reemerged to ask how “everything worked out” for me since he last checked in, more than two years ago. Not good. My New York shrink—the man who replaced him—had just dumped me.
Dr. Berg (not his real name, either) was a withdrawn “tell-me-more-about-that-thought” analyst. He had been there for me, at a steep financial cost, when others had exited my life. And now he was exiting mine. Who was going to be there now that he—a man who knows my every moral failing, every flicker of self-doubt—had decided to call it quits?
Dr. Berg said we weren’t making progress (yes, yes, I can be a stubborn patient) and suggested I see another “specialist.” Fair enough. But there was something off-putting about his tone—cold and aloof—as though we’d only met a handful of times. And I’d been handing him piles of cash to analyze me. Once a week. For a year and a half.
I respected that Dr. Berg was never an enabler, that when I wept on his couch he was understanding, not consoling; when I arrived late for appointments, my head bowed in shame, he was silently disapproving. Still, I valued his opinion, as us perennial patients are wont to do. I texted him that I would heed his advice and schedule an appointment with the specialist.
A week went by. Silence. Another week. Nothing. Maybe he lost his phone? Perhaps he had been hit by a car?
No, no. We were splitting up. That was that. And it was clear we would not even maintain a semblance of friendship.
I was dejected and rejected yet again by someone who cashed my checks to tell me how to deal with dejection and rejection. I hadn’t expected that someone paid to absorb my emotional trauma would end up contributing to it. So I did what I often do when going through a breakup: I talked to someone. A soothing voice, a relationship oracle. In my capacity as a journalist, saving me the $300 consolation fee, I called an expert for advice.
“If the therapist abandons the patient then that’s a bad termination [of treatment], because the patient can end up feeling like there’s something wrong with them. And that’s not true nor is it fair,” said Dr. Faith Tanning, a clinical psychologist who specializes in evaluating therapy and assuaging the neuroses of writers recently dumped by their therapists.
Was I wrong to be sour and cynical about the way he’d ended things? Dr. Tanning assured me that these feelings were not just ANTS (“automatic negative thoughts,” in therapy parlance).
“A therapist should absolutely follow up with a patient after treatment has ended, or at least they have to try,” she told me. “If a patient doesn’t answer calls, email them. And if they don’t respond to email, send a letter.”
But I hadn’t even received a perfunctory SMS message from Dr. Berg. His silence was “uncool and unprofessional,” as Dr. Tanning put it.
As much as I’ve wanted to apportion blame, it simply wasn’t meant to be with Dr. Berg. But like the end of a romantic relationship, the end of a therapist relationship leaves the jilted feeling robbed of precious time and emotional energy. Because the hardest part of jumping onto a new therapist’s couch, after investing substantial time and money with your old shrink, is bringing his replacement up to speed on your psychoses. Unlike a new romantic relationship, however, the first half dozen dates are spent oversharing and negotiating personal goals. In short, they’re deeply unfun.
Maybe one day I’ll run out of things to yammer on about. But for now I’m involved with a new therapist—and hoping he doesn’t dump me.