Lately I have been looking inward and analyzing myself as a therapist. My emotions sometimes become very strong, either during therapy sessions or after sessions are over. This can be very useful when directed appropriately, but also can be harmful for my own wellbeing. The awareness of these emotions and figuring out what to do with them has been extremely helpful for me. This post will focus on self-awareness when saying goodbye to clients.
One of the reasons for these recent efforts is that I have experienced strong connections with several of my therapy clients, and a few of them have recently left or completed therapy. One of these clients completed an evidence-based protocol at the VA I am working at. He did extremely well and was one of the most successful cases I've seen in my short tenure as a therapist. He was extremely insightful and had several "ah-ha moments" during our sessions. I'm sure it was enlightening for him, but it was also powerful for me. It was amazing seeing him grow throughout our sessions. It was also pretty cool to see how his trust and openness changed throughout our time together. When we first met, I thought to myself "This guy really doesn't like me!" because he was somewhat guarded and seemed annoyed at something I said a few times in our early sessions. One of my favorite things about longer-term therapy is the trust process and feeling connected with a person who has trouble trusting others. It was also a realization for me to see how effective cognitive-behavioral treatments can really be. Before this client, I had tried fragmented cognitive-behavioral methods with people, either very short-term or with people who have somewhat low insight. Needless to say it was minimally effective. With this client, we followed the Cognitive Processing Therapy manual exactly, and he was a really good candidate for it. This client showed me that CBT treatment can have a significant impact and improve a person's quality of life.
Another client recently was discharged from the state hospital where I work. He was someone in one of the groups I facilitated last year. He is someone who is known not to trust people and was often aloof, sometimes even hostile towards other people. He ended up really enjoying the group I ran (which is rare for him) and we spent about 10-15 minutes talking on the way back to his unit every week after sessions. After the group ended, I visited him every few weeks to see how he was doing. We had some really good conversations and I felt like I was one of the few people he trusted. He ended up being discharged much faster than any of us expected. I had to say goodbye to him last week. It felt pretty emotional for me, bittersweet for sure. I was really happy that he finally left the hospital after being there several years (and I know he was). But I will really miss him and our conversations. I will always remember our time together.
One of my individual therapy clients at the hospital is going to be discharged soon - likely this month. I have worked with him for over a year now. He has been ready to leave for a while (both personally and according to behavioral requirements). It will be really different not meeting with him every week, and I will miss seeing him. He will be the first person I've met with regularly at the hospital to leave, and a few others are slated to leave relatively soon. I feel like I am going to be more emotional for these moments when my hospitalized individual therapy clients leave than any other clients who have left or completed therapy. My individual therapy clients at the hospital have actually changed my life. My time with them has been an epiphany that maybe I am really meant to be a therapist, and not a researcher, which is what I thought for a while. I have connected on a level I never thought possible with my clients. I have seen enormous change with people. I am so grateful to them for taking healthy risks of sharing their life and their soul with me through our sessions. So when this client leaves, I am going to acknowledge what our time together has meant to me, and how grateful I am. He thanks me for my time frequently. But I am equally as grateful for his time with me.
My supervisors have given me some tips on how to terminate therapy. It is going to be really difficult with some of them. I am going to listen to my heart (while staying within my ethical obligations) and say goodbye with them how I feel fit. It is not the first time I will be sad about someone leaving, and it will not be the last.
