[Listen to an audio version of this blog HERE.]
"I meant what I said," he said.
And I said, "I don't think you do mean what you said."
And he said, "Sarah, you're being unreasonable."
And I said, "I don't care." And he said, "We're finished here."
And I said, "No, we're not."
And he said, "Sarah." And I said, "I'm scared." And he said, "I know, but you'll be okay. I promise."
This is a conversation I had with my therapist during our last session together. He told me he thinks I'm good now. "In remission," or something like that. My next therapist won't specialize in eating disorders because I'm well enough now that any old therapist will do. No need to take up space at the "specialized" table anymore.
Therapy is a funny thing. Lately, my eating disorder has not been the biggest, brightest, most prominent problem on my plate. Sometimes, it's off my plate entirely, and that's a really damn good thing. But sometimes, especially when the world's got me stressed, my eating disorder crops up again. If it's a good day, I can take the tools I've learned in therapy and whack-a-mole the eating disorder away. But sometimes, it lingers, loud as ever, knocking at my skull and begging me to let it back in. Sometimes I do, because it's so familiar and easy. It's like a worn in sneaker or a t-shirt soft from hundreds of washes.
But for most part, I do agree with my therapist. I am "in remission," now, or something like that. I've done so much work to re-configure my brain and un-learn a bunch of the disordered habits and beliefs I formerly held. I'm no expert (in anything), but I can speak from a place of extended experience when saying, there is a place and time to end therapy. My place and time coincided with a worldwide pandemic and the convenient retirement of my very patient therapist.
So without further pointless rambling, here are some signs that you might be done with therapy:
1. You're no longer distressed or in deep psychological pain.
This is especially pertinent if you sought therapy in the aftermath of an acute, stressful event such as the death of a loved one or the failure of an intimate relationship. Sometimes, we need professional help to grapple with a sudden loss, and that's a super healthy move. But, once we're not distressed or have come to terms with the loss, therapy may not be necessary. Obviously, you might find some deeper shit to work through, but often you might feel better. And once you feel better enough, it's healthy to shed the weekly therapy sessions, especially if, like many Americans, you're paying for therapy out of pocket.
2. You no longer feel heard/helped by your therapist.
This hasn't happened to me in a while, but sometimes you run into a therapist who sort of just sucks. Maybe they aren't the best listener, maybe you feel judged by them, maybe they're just going through the motions, or maybe you need someone with more sophisticated skills. You might need to "shop around" for a good therapist, so don't feel bad if it takes you a while to find one you like. According to the United States Department of Labor's Bureau of Labor Statistics, there are over 552,000 mental health professionals practicing in the U.S. today so you should be able to find one you like.
3. Your therapist has helped you enough that you can cope without them.
This is my current situation. I've worked in therapy to create new neural pathways in my brain, to essentially un-learn my disordered habits and completely disassociate my worth from my body. Trust me, it's easier said than done. Tabitha Farrar, an eating disorder recovery coach, describes neural rewiring in a podcast (listen here). In short summation:
"When you have an eating disorder your brain thinks things like calories and exercise are important. You pay mental attention to these things, which teaches your brain that they’re important. So you can’t expect your brain to just suddenly stop counting calories just because you’ve decided you want to recover now. Your brain has years and years and years of you teaching it via your thoughts, attention, and actions that counting calories is incredibly important. That’s also the reason that, when you decide to go into recovery and you decide you don’t want to count calories any more, your brains like, wait no this really important, you have to count this."
4. Your condition worsens.
You should never feel worse because of therapy, but you might. Health researcher Mike Crawford from Imperial College London says that those who have been marginalized in life (like non-binary folks, or those from different cultures) might find the experience of being offered help inherently unhelpful. Therapy effects everyone differently, but one way to mitigate a bad experience is to have a conversation with your therapist before you dive in. Setting boundaries and expectations often makes patients feel safe and increases their likelihood of having a satisfying experience. And this might sound counter-intuitive, but if you're having a bad experience you could bring it up to your therapist. Or, it might be time to find a new one.
5. You've outgrown them.
Maybe, you're too fucked up to be helped by them and need someone with a higher skill level to really address your fucked-up-ness. This might occur if you have a therapist who is fairly new to the trade, or a therapist who has simply checked out. As I've mentioned, you may need to try a few therapists until you find the right one. Therapists are like jeans. Finding one that "fits" can be a frustrating process, but it's well worth it.
P.S. If you don't have immediate access to an in-person therapist, try Talkspace, a low-risk online version of therapy. If you want some solid spiritual advice from one of the most prolific teachers of our time, check out the teachings of Ram Dass.