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The Script for Breaking Up with Your Therapist
Definitely don't simply ghost them
In Parts 1 and 2 of this interview, we learned about Dra. Ortiz’s background and went through the journey of finding a therapist, connecting with them, developing the therapeutic relationship.
Read those posts:
So how do you determine when therapy has ended?
Breaking Up with Your Therapist
Paulette: You're talking about the last day of therapy. Your job is to usher someone up into the next stage so that they don't necessarily need you anymore. But sometimes that is a proactive agreement. And sometimes it is a reactive situation. So...let's talk through this.
Mildred: I mentioned earlier treatment goals, a therapist who doesn't talk about the goals of therapy is a therapist who is just...I don't know what that is. You want to know what you're working on. You don't just want to go with the waves [or] shoot the breeze in therapy. That's, that's not helpful.
Paulette: Right, you're not there to be a friend.
Mildred: Yeah, no, I'm not there to be a friend. I'm not there to be your mentor. I'm not there to be your Jiminy Cricket.
I am there to help guide you, to help to challenge you, to give you perspectives, but ultimately the client has to make their decisions. They're the ones that are taking the lead on this, not me. I'm not the ones that have to live their lives, so I'm not the one who's going to be making decisions for them. And I have to communicate that to clients. No, I'm not doing that.
Mildred: Yes! Once you establish what the treatment goals are, then we are periodically going back and reviewing the goals. Okay, where are we in this? And I'm constantly using that as our basis for what the progress is. And every so often in the therapeutic process, I am taking the time to reflect on, not just how are we doing, how are you experiencing me?
Is there anything you need to talk about with me? Because I tried to provide that open space for them as well. It's okay, clients get mad at me all the time. And that's something to process. I don't take it personally because at the end of the day, it's not really about me.
So we reflect, we talk about treatment goals. We're constantly assessing and seeing where they are. And then the approach that I have with them too, is more likely than not, I'm seeing them on a weekly basis. Once they hit a certain milestone, all related to the treatment goals, then I have conversations with them, like should we go bi-weekly? Then once they hit another milestone, then let's go once a month.
Because I want them to gain that confidence in themselves that they don't “need me.” They've never needed me. That's the reality. These issues existed before I existed in their minds. It's really just applying something new to work on the issues that they've been experiencing for who knows how long.
So I want them to build on that confidence and that self autonomy. And when we start transitioning over to the once a month, I give them a heads up. If we're moving to once a month, that means we have three sessions left and this is what it's gonna look like and this is what we're gonna do.
It is my responsibility. I know what the therapeutic process is. They don't, it's my job to communicate that to them, so I do my best to always give them insight into that and prepare them for that.
(That's my approach, though. I don't know how other therapists do it.)
And then, we talk about it. It gives them opportunities to really process their worries, their fears. “But what if I need you? What if something happens?”
Well, life happens. And if it happens while we're in this process of ending, we'll process it, but it doesn't necessarily mean we're going to continue. So I give them that insight.
Paulette: Because by that point, they'll have some tools where they can manage that, right?
Mildred: They'll have the tools, yes.
Paulette: So they don't necessarily need you, even though at the beginning they might think that they do, because that sounds like a scary thing in the future.
Mildred: It is a scary thing in the future, and that's why the tapering off is really helpful. Because after three weeks of not meeting with me, and then they're like, “yeah, I went through these little incidences and I did experience anxiety, but then I did this and I did that and I was okay.”
So there's this level of readiness and they're seeing it themselves. And by that second session into like the three sessions, I asked them, “should we go one more? That'll be the last one.”
And I want to say like seven out of ten will say, “yeah let's go that last one.” And then there's three that will say, “you know what, Dr. Ortiz, I think we're good here.”
So giving them that opportunity. And if we think about it, it's not a breakup, it's a ending. Like the end of a chapter of a book, the end of the book.
Paulette: It's kind of like physical therapy in that you go in, you have an acute issue. So maybe it's not as acute with a patient going to a mental health therapist. But if you approach it thinking like it's physical therapy, you are being treated so that you can then live your life without physical therapy so that you are stronger and still have full use of your faculties—that sounds a lot less scary.
The Script for Ending the Relationship
Ending any relationship can cause anxiety, especially one in which you’ve been vulnerable with another human being. Dra. Ortiz gives you the word for word script for effectively ending the relationship, and the two big reasons why you shouldn’t ghost your therapist.
Mildred: Yeah, that it's a process and it's just a chapter in your life and it doesn't have to be a breakup because I think the breakups come with so much anxiety and emotional highs and lows. And let me tell you, breakups do exist. Sometimes they come from me. Very rarely do they come from me, but it has happened.
But usually it's the other way around. I haven't had a lot of clients who have broken up with me or who have ended therapy with me because they are not happy with my approach.
Like I said, I'm not for everybody and that's okay. I don't take it personally. And if you just aren't feeling comfortable or you don't like the approach, it's okay to say:
“Thank you, but no thank you. I think I need to find someone else who is going to approach the issues that I'm addressing in therapy differently for me. I'm looking for something else.”
And that's okay. I appreciate that. I think it's the ghosting that I don't like.
Paulette: So that right there, do not break up with your therapist by ghosting them!
Mildred: And the reason why is it just highlights your issues. And if you tend to do that, oh, I understand what you're doing. This is what you do!
Paulette: Same old pattern.
Mildred: Same old pattern. But what it does for me is like, do I keep you open or not? Are you going to respond to me or not? I need to close out your case because if you're not my client anymore, I don't want to keep your case open.
So it's out of courtesy.
Just like it's out of courtesy if like, you're not interested in the person you went out for a meetup or a date or whatever, just out of courtesy:
“Thank you, but no thank you. I'm looking for something else.”
You can use the same sentence for the breakup.
Paulette: Do you prefer it in a text or on a phone call or voice mail?
Mildred: I'm traditional in that sense. Talk to me about it. I'm not going to bite. I'm going to appreciate your honesty and your openness. And it's also a corrective experience for them to know that I'm not going to yell and tell you off because...
Paulette: Because you're not the girlfriend.
Mildred: I'm not the girlfriend or the boyfriend or the partner or whatever.
Why a Therapist Could End the Relationship
Sometimes a therapist ends the relationship with a client for reasons that might surprise you. Here Dra. Ortiz illustrates a scenario where she had to end therapy for her client.
Mildred: And yes, there have been times where I have had to end those therapeutic relationships. And let me explain that a little bit because it's not like, oh, I don't like you. That's not the way that it works. That's very unethical.
It's more about you're making me feel unsafe. Now you're threatening my life. Or you're saying things that are very insulting and I'm not going to stand for that, so we're going to end here.
Paulette: Yeah, the space has to be safe for you as well.
Paulette: I never even thought of that.
Next time I interview Dra. Ortiz we’re going to discuss boundaries. She’s an expert in creating boundaries especially in a traditional Latine family system.
Get the conversation started by telling me: what questions do you have about boundaries? Leave them in the comments below so I can include them in the interview.👇👇👇
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