I’m going on holiday and I won’t be able to see you that week:
Abandonment and the therapeutic relationship
by Ruddy

 

My therapist went to a conference this weekend. I felt like she had abandoned me and was running away from me. My session was a day late and it felt like I hadn’t seen her for years. We were in constant contact but it felt like she was avoiding me.

These are difficult feelings to manage, particularly when my safety relies on the consistency and stability of the therapeutic relationship. These feelings are even harder to tolerate when I feel like I’m being unreasonable and irrational. This article will look at why I feel like this, in the hope that it will apply to you too, and it will suggest ways to manage and reduce these feelings of abandonment.

Why do I feel abandoned?

There are a number of reasons that I have found for why I react in an extreme way to any disruption to therapy.

Firstly, it takes huge trust to go to therapy at all. I have been tricked and betrayed many times, and this and my abusive experiences in general make it very difficult to trust anyone, let alone to trust them with my secrets. It can often feel that I am putting myself in life-threatening danger to go to therapy and sometimes I feel very suspicious of my therapist. It requires a lot of faith in my therapist to feel confident enough to begin to tell my story and to feel that my therapist can be trusted with what I am telling her.

If I feel that therapy has been disrupted in even the slightest way, this feels like a threat to the safety and stability of the therapeutic relationship, and therefore a threat to my trust. If my therapist has gone away for a few days, I feel very suspicious that this is the point at which everything is going to go wrong, everyone will find out my secrets, and I will be in trouble. I then often go further than that and feel that she definitely has abandoned me, which feels like a horrendous betrayal of my trust and is very destabilising.

Secondly, therapy requires me to be open about my needs – and I really need my therapist. Gradually I am more honest with my therapist about what I need from her and how important she is, so if she goes away, I feel like I have been humiliated as well as abandoned. There is a big risk in being open and the vulnerability of it makes me feel exposed, so I need things to stay very stable and consistent to help me to feel that the risk hasn’t gone wrong.

Thirdly, I think in an all or nothing way. My therapist is either here and committed to me, or she has gone and I will never see her again. It is very difficult and requires disciplined thinking to even consider the thought that maybe it is somewhere in between and she has gone but is still committed to me – let alone to believe that thought. I find it uncomfortable to consider grey areas and it is much easier to think in black and white, even though the black thinking is very distressing and not very helpful.

Fourthly, I have Dissociative Identity Disorder, and there are parts of me who are children. These parts think in childlike ways, which are also very all or nothing, and their world view is based on traumatic experiences. These children believe that my therapist is there when she is there, but when something changes it is difficult for them to have a bigger picture or understand the concept of a long term and committed therapeutic relationship. These children just feel abandoned and sad. This doesn’t only apply to people with Dissociative Identity Disorder, because I believe that everyone has elements of themselves which are more childlike.

Fifthly, I don’t cope with change well. I like it when things stay exactly the same and I find this very reassuring. When things change, I feel frightened and threatened. The concept of a world which is dynamic feels alien and threatening to me and I resist every change as strongly as I can. This is particularly important in the therapeutic relationship, which should be as stable and safe as possible. So when circumstances change, even if only temporarily, I feel very unsettled and anxious.

There are more reasons why I can feel abandoned by my therapist, but the simplest way to explain it is this: what I have been through has given me a lot of issues with attachment and trust, and I need my therapist to stay as safe and stable as possible so that healing through the therapeutic relationship is possible. If I feel that there is any disruption or unsettlement in the therapeutic relationship, I try to protect myself by making predictions about what will happen, and I act and react to that. However, these predictions are based on a world which is different to the one I live in now, so what should protect me ends up hurting me.

Why shouldn’t I feel ashamed of feeling like this?

These strong feelings of abandonment, distrust, and fear are completely normal. I don’t think I’m the only one who feels like this!

Feeling abandoned because of even the slightest change is a logical response to bad experiences. Further than that, the experience of therapy requires me to make myself vulnerable, in a safe and supportive place. It is important to become vulnerable and open in this way because it is only by doing this that I can be honest about what I need and move towards having those needs met. This vulnerability can at times be excruciating and can make me feel abandoned, but it is an essential part of the healing process through therapy.

If I turn the situation around to look for positives, I can see that these feelings of abandonment can actually be a sign that things are going well in therapy. For me to feel abandoned, I have to feel that the relationship is important. So if I am feeling abandoned, it means that therapy has reached the point of becoming important and valuable to me, and that I am becoming attached to my therapist. This might feel scary but it is actually a very positive thing that shows progress.

Also, it is important for me not to forget that my therapist is a professional. The majority of us who have therapy go through a phase (mine has been a very long phase!) of feeling so vulnerable that we feel abandoned after the slightest disruption. This is part of therapy, because it is an aspect of relearning attachment. So this is a part of my therapist’s job, and she has seen this many times before.

What can I do to make the feelings more tolerable?

Here are some suggestions which have helped me to cope with feelings of abandonment:

  • Make contact with your therapist. This depends on the therapist and on the boundaries you have in place, but if you are able to send a text or an email, do so. Don’t feel proud or isolate yourself. If you’re missing them, contact them.
  • Start a countdown. Work out how many days it is until they are coming back and allow yourself to look forward to it.
  • Distract yourself. Arrange other things and meet up with other people. Try to make the time go by pleasantly rather than isolating yourself.
  • Talk about it. Maybe you could do this with a friend or other supportive person, maybe with your therapist, or maybe with yourself in your journal or out loud. It is helpful and important to acknowledge what is going on and how you are feeling.
  • Tell your therapist. It can feel excruciating to do this and it can feel like a big risk, but it probably won’t be a surprise to them. Therapy is about being open and honest, and it can be a step forward to talk about how you are feeling about it. You might also be able to put things in place to make it easier next time, or talk about ways for your therapist to notice when you are feeling like this.
  • Do other therapeutic things. Just because you are feeling like this about your therapist doesn’t mean that therapeutic work has to stop. Carry on with any expressive things that you do like writing and being creative. If you go to other therapeutic groups or activities, carry on with them.
  • Look after yourself. Be aware that these feelings of abandonment will have an impact and might make you feel a bit low. It also might make you more sensitive with other people in your life. Be aware of it and look after yourself.

What can I do when the abandonment turns into anger?

It is quite common for feelings of vulnerability and abandonment to turn into anger. This is a defensive mechanism to try and protect you from being hurt if you are feeling vulnerable. However, it is not helpful to keep it inside or to make decisions based on it.

I have found that it is a good idea to talk to my therapist about what is going on. It is important to acknowledge my feelings and it is helpful for her to know how I am feeling and that they have had an impact on me.  She might be able to tell me her side of the story and explain anything that I feel hurt by. It can be very helpful to be able to tell my therapist that I feel angry with her and to talk about it, and it can feel very healing to be met with a listening and accepting response, and even to get an apology.

I try to be aware of the reasons for why I feel angry. It helps me to remember that it is a defensive response to feeling vulnerable, and not necessarily a response to my therapist doing anything wrong (unless she has also done something wrong). This is important to remember because it would not be sensible to take action like quitting therapy based on these feelings. It is always more helpful and effective when I deal with the root cause of a feeling, and in this case the root cause is how the openness and vulnerability of the therapeutic relationship makes me feel and why.

It helps me when I find ways to express how I am feeling. Anger is a difficult emotion to cope with. I try to be creative: I draw, paint, write about, sing about, and generally try to be creative in expressing how I feel. Sometimes I try doing something physical like going for a run. Occasionally I allow myself to express it by having a little shout or a cry. It is crucial that I express how I am feeling in some way, and before it turns in on myself and becomes destructive and harmful.

Sometimes a disruption to therapy can have a negative impact on therapy, and it is important to try and deal with this as soon as possible. When my therapist is back, it is very important to address the issues and talk about them. Every rupture which is addressed and dealt with is a big achievement and will strengthen trust – but it is essential that it really is addressed and dealt with.  It is also important for me to try and hold onto hope that things will get back to normal. I read through old emails to remind myself that my therapist is worthy of my trust, and try to get through the period of rebuilding that trust.

How can I prevent this from happening again?

Unfortunately, I can’t, or at least not for the time being. These feelings are part of the therapeutic journey, as I become open and fully engaged with my therapist, and as I start to heal. I have found that the foundations of the therapeutic relationship have got much stronger over time, which helps me to stay rooted. However, there are things I can do right now to make it more manageable, which might help you too: forewarned is forearmed.

 

  • Know about yourself that you feel like this when there are disruptions in therapy. That way it won’t be a surprise and you will be able to recognise it more easily.
  • When your therapist tells you that they are going away, start to plan other things to make the time more bearable in between.
  • Talk together about when you can be in contact.
  • Be open with your therapist about how difficult you find it.
  • Ask your therapist to write or record something to remind you that they are coming back and that they don’t hate you and haven’t abandoned you.
  • Have some kind of check-in with another professional while your therapist is away, like going to see your GP.
  • Arrange interesting and fun things so that you don’t feel like you are missing out.
  • Write or tell yourself reminders that your feelings are normal and logical.
  • Read old emails from your therapist to remind you of how the therapeutic relationship is.

Above all, try to look after yourself during the gap time and remember that your therapist is still committed to you and that how you feel is normal and logical.