The End of Therapy
How to Know When You Are Done.
Here’s something about me many of you don’t know: I have published 13 books under three separate names. Two are pseudonyms.
Fiona Rosenbloom, my first pen name, wrote a series of young adult books that came out in 2005 & 2007.
Yesterday, an updated version of the 2005 book was re-released. You can buy a copy of You Are SO Not Invited to My Bat Mitzvah! for your favorite tween right now!
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Now, onto my favorite topic: THERAPY!
If you haven’t seen the dedicated Therapy issue of the New Yorker, it’s a must-read.
Last week was one of the most significant weeks of my adult life.
On Wednesday, July 19th, at 5:15 pm, after 23 years together, I had my last therapy session with my beloved therapist, R.
I started seeing her in 2000.
There were times I took months off, and for the past two years, I’ve seen her only twice a month, but for 23 years, R has been my ride-or-die.
She was the most consistent thing in my life, my longest relationship, and ultimately, a bonus mother.
So why did it end?
I successfully individuated.
Our pal, Carl Jung, originated the concept of Individuation, separating from others while maintaining one’s unique identity and sense of self.
Individuation is both a life goal and a lifelong process. Jung, however, was clear that he saw the act of individuation occurring in the second half of life.
Not so Michael Fordham and Margaret Mahler, two 20th Century psychiatrists studying childhood development. Because babies are born into a state of symbiosis and don’t realize for at least the first four or five months of life that they are separate, Fordham and Mahler believed that individuation is a process that begins in infancy.
Learning that they are separate from their caretakers is a process known as Separation-individuation.
According to Mahler’s model, at around two years old, a child develops a sense of personal identity and a stable mental representation of the mother or caregiver, even in their absence.
Successful navigation through separation-individuation allows the child to develop a healthy sense of autonomy and a stable, individual identity.
Parents play a crucial role in this process by gradually increasing levels of independence and fostering the child's self-confidence. During this period, parents must accept the child’s feelings to help advance the healthy progression of establishing a strong separate identity.
However, suppose parents are excessively protective or anxious. In that case, the child may experience feelings of inadequacy and self-doubt and become “stuck” in that developmental stage, insecure and overly-dependent on others for their well-being.
Because I had undiagnosed panic and anxiety, which organized itself around separating, I became stuck in this stage and could not feel safe being away from my mother. It was clear I suffered from separation anxiety. But because mental distress is invisible, it wasn’t clear to others how its manifestation of annihilating dread impeded my daily functioning and sense of safety, security, and self as separate from my mother.
The process of individuating accelerates in adolescence and young adulthood, but because I wasn’t diagnosed until I was 25, I was never helped and remained feeling developmentally stuck. When the process of individuation is hindered, it leads to anxiety and a lack of a defined identity.
What an excellent therapist can do for those with individuation and separation issues is help them successfully navigate through the stage of stuckness, work on communication issues, boundary setting, confidence-building, self-concept, agency, and purpose.
And that is what my therapist did for me.
When you go undiagnosed and untreated for so long, you are bound to have more than the original disorder. By the time I was diagnosed, my panic and anxiety disorder had grown up, married, and had baby disorders. When I started therapy in 2000, I went in with these diagnoses: Panic Disorder (extreme), Clinical depression, Agoraphobia, suicidal ideation, and Dysthymia!
My therapist saved my life, grew me up, and helped me shape and solidify my identity and sense of self. When I began therapy, I didn’t know who I was, what I felt, or how to live. When I began therapy, I saw her three times a week.
I remember early on when she said I needed to learn to “take care of myself,” and I had no idea what she meant. Like, no clue. Whenever she’d bring up something related to my emotions, or things that happened to me in childhood, I’d make a joke and flick it away. I don’t know how many years she spent saying, “You’re laughing, but it’s really quite sad.”
From the start, I was ashamed of having feelings. I was stuck in a persona that had, for 20-many years, protected me from exposing my panic attacks, even while I was having them. Being human out loud and in public felt mortifying. I was so tethered to my sheathing that I couldn’t see that I was wearing it or it was wearing me.
I genuinely thought my defenses were my personality.
There was a time when I couldn’t have imagined living without her.
In fact, an old boyfriend wanted us to move out of the city; my first fear in that Zoom-less era was not being able to see her. When a different boyfriend was cast in the European tour of Cirque du Soleil’s Saltimbanco in 2002, the first thing I did before flying to Europe to spend the year traveling with them was to figure out a way I could get a dial-up connection so I didn’t have to miss my weekly sessions.
But in the past few years, something began to shift, and I started to feel antsy and more ready to live without therapy.
Writing this newsletter plays a pivotal role in my sense of self and purpose. Without your support and emails, interest, and positive feedback, I’m not certain I’d have reached the point I have at this exact moment.
This newsletter has accelerated my growth. Spending hundreds of hours a month reading, researching, thinking, talking, and writing about psychology and mental health has cemented in me the sense that I matter.
Whether or not you believe I matter is beside the point. Rather, it’s the state of feeling that I do that is healthy and was missing in me for four decades.
When I began therapy, no one outside of my family of origin knew I had a panic disorder. Since then, I’ve written a memoir about it and have spent years traveling the country talking to schools, parents, and teachers about my experience, the difference between typical and atypical anxiety, how to identify anxiety in others, and how to manage it.
Now, 23 years after struggling to admit I suffered, I write about psychology and mental health every week.
I entered therapy to treat my panic, a disorder that prevented me from successfully separating from my mother in childhood. This inability to separate has to do with a fear of disconnection. When that fear is pathologized, one’s ability to discern who to connect to is imperiled.
And that’s when one can choose the wrong people.
My therapist taught me how to live with the uncertainty inherent in separating. Learning to tolerate that liminal space liberated me from connecting to the worst kinds of people.
It took me decades to trust my experience and act on my intuition. It took me decades to tolerate uncertainty and to end platonic friendships and romantic relationships with people who couldn’t tolerate my feelings or respect my boundaries.
Having reached those markers, I began to feel ready to go at life alone.
When I brought up my feelings several months ago, I assumed I’d have one more session, and that would be that. But that’s not how my therapist rolls.
She heard me, and she agreed. I was ready.
And then, she rolled out the three-month termination plan. Her goal was to ensure I synthesized absolutely everything I learned in therapy. It was like off-boarding boot camp.
In these past three months, she made certain I understood everything I’d learned, and I made certain she understood how much she meant to me and the impact she had on my life.
I listed all the things she taught me how to do, including organizing my disorganized thoughts, knowing the difference between my gut and my anxiety, how to draw and communicate boundaries, how to properly interpret my dread, how to separate from unkind people and those who take me for granted (and there have been many).
And I thanked her.
Last week, we said goodbye. She asked me to keep her posted about some things, and I promised her I would, and perhaps it’s the promise that she is still available to me and not gone forever that gives me the strength to face the world alone.
And you? Have you gone through the process of terminating therapy? What was your experience? If you feel so moved, please share in the comments…
Until next week, I am...
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