Why People Leave Psychotherapy Prematurely

counselling

Needless to say, most psychotherapists dislike when their clients decide to quit therapy prematurely. They have a variety of reactions. Some become upset when their clients complain about lack of results, and there are also those psychotherapists who throw a temper tantrum when someone informs them that they want to abandon therapy!

One of my clients (I’ll call her Joanne), a forty year-old woman, broke up with her partner because she caught him in bed with another woman! He kept contacting her on a daily basis. She felt attracted to him but was not sure about her feelings. Joanne told me that she was still in love with him but didn’t want to continue the relationship. She was anxious because her mind wanted to forget her ex but her heart desired him. She needed help to clear up her thoughts and emotions.

I asked her what she had done so far to solve her problem. Joanne explained that she had been seeing a psychotherapist for ten sessions without any positive results. She had spent about $700 for a therapy that wasn’t helping. For this reason, on the tenth session, she informed the psychotherapist that she decided to quit.

As soon as her therapist heard that Joanne didn’t want to continue the therapy, she became upset and threw a temper tantrum! The psychotherapist, a psychiatrist specializing in psychoanalysis, criticized her by saying things like:

“You can’t stop our therapy now because you are worse than you think you are.”

“You will continue your blind steps.”

“That trip you mentioned with your son, it’s just an excuse. Instead of spending your money on this trip, you should be coming to therapy twice a week!”

After few weeks, Joanne sought my help. It took Joanne three sessions to sort out her mixed emotions and clear up her thoughts. She overcame her anxiety and was congruent about her decision to avoid her ex and start her new life.

Most therapists don’t realize that they are selling a service. People have the right to hire and fire them. Clients bring a problem and want a solution. Competent therapists know this. First of all they are good at what they do and in most cases are able to make a difference in the lives of others. Secondly, they don’t get upset or blame the client for wanting to drop out prematurely.

It’s true that there are some clients that are difficult to work with and they sabotage the treatment. However, most people seeking help have a desire to cooperate, and if they show any resistance is because of fear of change. A professional therapist must have the necessary skills to help clients solve their problems, regardless of their degree of cooperation and resistance. Labelling a client as “resistant to change” denotes mediocre therapeutic skills.

References:

Ogrodniczuk JS, et al. “Strategies for Reducing Patient-Initiated Premature Termination of Psychotherapy,” Harvard Review of Psychiatry (March–April 2005): Vol. 13, No. 2, pp. 57–70.

https://uit.no/Content/418448/The%20effect%20of%20CBT%20is%20falling.pdf

Wu Wei: Let It Flow

water
For some people life seems tought! No matter how much they struggle, they cannot reach their goal. If you can relate to this, maybe you are trying too hard!
 
Wu Wei is the art of letting your life flow without excessive effort. It means being flexible enough to adapt yourself to ever-changing circumastances. Like a flexible tree branch that bends under the weight of the snow and remains intact.

Wu Wei is one of core principles of Taoism. Lao Tse repeatedly mentions it throughout his well-known Tao Te Ching. Wu Wei means “non-doing”, however, despite this literal translation, it does not refer to “doing nothing”. Lao Tse’s advice is to live life without anxiety. Wu Wei refers to acting according to the circumstances with a serene attitude and regardless of their outcomes.

In other words, Wu Wei is a practice of detachment. Let’s say you have a goal. Once you decide what you want, you begin taking actions toward your goal. However, your actions and thoughts are free from the anxiety of achieving it. You work toward your goal without excessive effort.

This may sound like a paradox. You may ask, “How can I achieve a goal with this principle of non-action?”

Let’s see an example. Most smokers who give themselves an ultimatum, have a lower probability to succeed. I-must-quit-or-else- attitude generates anxiety that sabotages their goal. It works better when smokers make a firm decision to quit but are relaxed about the outcome.

Lao Tse encouraged people to live their lives spontaneously. Instead of forcing the situations or getting upset and anxious when the circumstances don’t turn out as you wish, you can let it flow!

“Tao invariably takes no action, and yet nothing is left undone.  If the lords can keep to this, all things will transform with spontaneity.” Lao Tse

Why Men Cannot Read Women’s Subtle Messages

Joe

After almost a year of separation, Joe, a thirty year old man, and his wife signed the divorce papers. What must have been a relief became an anxiety-producing event for Joe.

After signing the papers Joe and his ex wife went for a walk and had lunch together. She, who had been acting distant and cold since their separation, showed a warm and nurturing attitude toward Joe.

For most people her kind attitude would have seemed normal. However, her kindness caused Joe much confusion because suddenly he felt attracted to her! The same woman, who, according to Joe, had caused him much suffering, now was so kind to him. Joe felt that he still loved her but wasn’t sure about his feelings.

This anxiety and confusion were the reason Joe contacted me for an online session.

I recommended Joe to avoid talking or writing to his ex for couple of weeks. This would allow him to reflect on his feelings and clear up his thoughts in order to make the right choice.

safe

Men are Clueless

Usually men are clueless when it comes to read women’s subtle messages. It’s like opening a safe without either the combination or the key! Unfortunately (for men) women do communicate with indirect cues and non-verbal messages.

Several studies have shown that men mistake friendliness with sexual interest. Women’s communication is rich with emotional subtleties that female friends are good at deciphering. However, most men lack the skills of reading female’s non-verbal communication.

Joe, an emotionally vulnerable man, who has been suffering mainly due to loneliness, suddenly receives kind attention from a woman who once loved her. Joe, an emotionally hungry man, was confused because he failed to recognize that the attitude of his ex was not love, but kindness.

First of all, most women are polite with their ex. Secondly, it’s possible that she felt pity for Joe. She must also felt guilty. Politeness, pity and guilt were the main ingredients of her attitude to nurture a broken man.

Joe, however, interpreted her attitude as a green flag to get back together. This “lost in translation” phenomenon was the cause of his anxiety. It’s beside the point that she clearly communicated her desire to have a separate life by signing the divorce papers! Joe, like many vulnerable men, distorted the reality and saw what he wanted to see.

I Castrated My Husband!

tough

Woman: I’m afraid of my husband’s seven-year-old son. He is seeing a psychologist for Attention Deficit/Hyperacivity Disorder (ADHD) and for his violent and vulgar behaviour.

She caressed her round belly and added: “We are expecting our first child together, and I’m scared the boy would hurt my baby.

–Do you two live together?

Woman: No, I own two flats in the same building. I live in one of them on my own, and my husband and his son live in the other flat on the next floor.

The husband was listening and nodding with a gentle smile.

I asked the husband: Do you feel at home when you come downstairs to be with your wife?

Husband: No, because I prefer that we all live together but I don’t want her to get upset. I love her and want her to be happy.

I said to his wife: “It seems that you have sweetly castrated your husband!”

She smiled and after a pause she said: My previous marriage was a disaster.  My ex was dominant and agressive. I don’t want to go through that again. So, yes, I castrated my husband!”

–Do you really want to have a castrated man in your life?

Woman: No.

……

Often couples carry their past with them in the next relationship, and then, they complain that they are not fully happy.

Our problems become easier to handle when we let go of our past.

She Insults me but I Love her!

angry

Tom, a 30-year-old man sought my help for anxiety relief. He was crying every day and didn’t know what to do about his anxiety.

The following is a portion of the conversation I had with him:

Tom: My wife left me one week after our wedding day! She said that she had rushed into the decision of marrying me.

–How long were you two dating?

Tom: We were living together for about three years. Everything was fine. I just don’t understand it. I cry and cannot stop it. My mother is distraught and doesn’t know how to help me. I feel so bad crying in front of her.

He told me that if he tried not to think of her but lots of things remind him of her ex. If he heard a song that she liked, he couldn’t control his tears.

Tom: I still love her. We talk on the phone and I cry and tell her how much I miss her.

–How does she react when you cry and plead?

Tom: She is cold and insulting. She tells me that I’m weak that I cannot get over her. I can’t help it, I still love her. We do lots of texting to each other. I’m so polite with her but she is rude and demeaning toward me.

Tom told me that his ex had hired a lawyer to process the separation and divorce. He knew that it was over but he couldn’t help loving her. His mind knew that this relation was over but his heart wanted her back!

–Blaise Pascal said: “The heart has its reasons which reason knows nothing.”

Tom smiled and understood that it would be useless to fight his feelings or trying to control them with his rational mind.

Tom: You are right, I cannot reason with my heart. But what should I do?

I gave Tom a task to be able to express his emotions. I also ask him to do an experiment for a week. I asked him to change his attitude toward his ex from being warm and available to being cold and distant. He agreed to carry the task out for one week as an experiment. He would, among other things, avoid responding to her messages immediately, and when he replied, he would use few words and maintain a serious tone.

One week later

Tom was bewildered! He said that he had to go to pick up his belongings and through the half an hour he was there with his ex, Tom acted very distant and cold. He said that it was difficult not to plead as before and cry pleading her to come back but he was firm and said few words.

At one point his ex hugged Tom from behind and talked to him with a gentle voice telling nice things to him! Tom was shocked! He couldn’t understand why his ex had changed her attitude. When Tom was pleading her and crying, she acted cold and said nasty things to him. However, when he acted cold and distant, she was warm and gentle.

The next day Tom did an experiment on his own. He acted as before: replied her messages immediately; used a warm and polite tone when talking to her and expressed his desire to have her back in his life. To Tom’s amazement, his ex responded rudely and insulted him.

Tom: I learned my lesson. I decided that I don’t want to be around someone like her. I deserve better.