The Sudden Desire to End Therapy: Resistance or Wisdom?

Often when clients suddenly decide they want to end therapy, therapists are encouraged by the ‘therapy culture’ to think of it as some kind of resistance to the process. I wonder, is this necessarily the case?

In psychodynamic counselling theory, the relationship between client and counsellor is seen to a significant extent as a transference relationship — that is, as a kind of re-enactment of an early attachment relationship, that first intimate bond with a parent, as first point of contact with the world, which we can assume, if the client is in therapy, went wrong somewhere. Hence, the desire to suddenly rupture that relationship may be interpreted as a rebellion against the parent. In other counselling models, it might be seen as a desire to escape from difficulties or emotions brought up by the process, or from the sheer hard work involved.

My sense is that very often the desire to ‘escape’ therapy is a sign of health. I think that counselling should essentially be about attuning to the client’s own sense of power and agency, and once it rises to the point where the client wishes to leave, this is a good thing, irrespective of whether the client feels entirely ‘better’ or whether the counsellor feels that the whole process has been completed. If the client feels that their power and agency is in any way held in check by dependency on the counsellor, or that they cannot entirely express it in all its mess and glory with the counsellor, then the impulse to leave is a healthy one. There are also cases when the client just knows that they aren’t ready to go any further. This also needs to be respected rather than over-interpreted.

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In general, the interpretation of wishing to leave as resistance to a process, be it therapeutic, or spiritual, seems to me worthy of investigation. If any desire to leave or a disagreement that one person has with another is defined as resistance (and especially if it doesn’t work the other way around), this seems actually to be a pretty good working definition of an abusive relationship. The one with control is also the one who possesses full information about the situation and may use it to back themselves up. Does the client even know exactly what process it is that they are supposedly resisting? Not to mention the fact that the one with control over the information and the interpretation of the situation is usually getting paid. There is undoubtedly a power relation in play.

I’m not suggesting that counsellors attempt to hold clients against their will, but I sense that the idea of leaving as resistance functions in what I am calling the ‘therapy culture’ — a kind of set of default assumptions shared by counsellors/therapists of all different theoretical bases, filtering through each one of those therapeutic orientations in a slightly different way. Of course these assumptions about clients suddenly leaving applies only to long term therapy, which nowadays almost exclusively means private practice. If you are seeing a counsellor on the UK’s National Health Service, for example, six sessions is all you are going to get. Leaving before the end in this case may mean simply that counselling was not actually what was needed, and the client went along to try it because that is what the doctor prescribed.

In the case where the client is paying and obviously has decided that counselling is what they want, there may also be a mismatch between client and counsellor: they may not feel they are getting what they need and prefer to vote with their feet rather than bring up the issue with the counsellor. This may be not a ‘ducking out’ of a deep and difficult issue which has been triggered, but a wise common sense decision. There are so many factors at play in whether the relationship with a counsellor will be helpful to you, factors which can’t be enumerated or ‘checked for’ in advance. The client may not be explicitly aware of them even at the time. And there are so many factors of time and money and relationships out there in the actual world of the clients’ life, that crystallise in the decision, that the counsellor will not be aware of. There is also the possibility that yes, the client is ducking out. This opens up the possibility that they will come back when they are ready — which often happens, in my experience — people returning for a ‘second round’. The counselling process can’t be rushed or forced, and sometimes this involves leaving it altogether.

It also seems to me that the ‘just knowing’ that this particular counselling relationship, at this particular time, is not what you need, is the very kind of ‘just knowing’, trusting that and acting on it, that is the aim of counselling itself.

• in practice
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• therapy