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  • Erika Nichols-Frazer

Ending Therapy



Today was my last therapy session. It was via Zoom, which has been the case for a year and a half. It was sort of anticlimactic. We talked about how it feels to end therapy after a really intense four years of working together, and the things that are on my mind, knowing we won't pick up the thread next week. Betsy told me how much she'd enjoyed working with me. We reflected on the last four years together, which saw me through separating (for two weeks) then reuniting with my husband, grad school, new jobs, buying a house, a series of manic episodes and panic attacks, and lots of joy. So many triggering moments and freak-outs. A lot of crying. But, as I told Betsy today, "I feel like I have more tools in my toolbox than I did four years ago, that I'm ready for whatever gets thrown my way."


The last time I quit therapy was 2013, two days before my mom fell down the stairs and sustained a traumatic brain injury. My therapist was leaving the state and things seemed pretty stable in my life. I told her I didn't need a referral. I didn't want to start from square one again. When my mom landed in the hospital days later, my then-boyfriend said, "You know you could call to get that referral," but I decided I just wanted to handle it on our own, get through it together. I really needed someone to talk to and somewhere to vent my stress during that time and wish I'd sought help. I didn't see a therapist for four years.


Shortly after we'd gotten married in 2015, I stopped taking anti-depressants, with the help of my psychiatrist. I'd gone off anti-anxiety meds a few months earlier and things seemed to be going fine. I was a newlywed; everything seemed perfect. I could tell something was wrong almost immediately after going off all meds, but I wanted to prove to myself I could survive without chemicals. I was determined to be OK; I wasn't. It took a winter of feeling constantly sick and depressed before I admitted that I needed help. I asked my psychiatrist to refer me to a new therapist and the match was the best I'd experienced. We started out with one session of psychotherapy a week. I was leaving my job to go part-time at a nonprofit closer to where I lived and was hoping to go to grad school. I'd had a traumatic ectopic pregnancy that had nearly killed me and still had a lot of grief and messed up feelings about that. I also had tried to stage an intervention for my mom a few months earlier and that had not gone well. There was a lot of stress around my mother's health and drinking. Things between my husband and me were tense; he was pulling away and I felt like I was drowning. A few months into therapy, after a fight, I had the worst manic episode I'd had to date (I didn't know that's what was happening at the time; it felt like my life was falling apart) and separated from my husband for two weeks. After that episode, Betsy suggested we try psychoanalysis three or four times a week.


I managed three times a week for a while, which involved driving an hour each way for every session, as well as paying out-of-pocket, as our insurance didn't cover psychoanalysis. I cut it back to two days a week after I, drowsy from an early-morning session and new medications, fell asleep at the wheel after therapy on my way to work, totaling my car. I couldn't keep doing this.


Psychoanalysis is intense. It's different than 'regular' pyschotherapy. For one thing, it's what you see in that classic TV image: a patient lying on the couch, tapping into their darkest and most painful dreams. In our case, Betsy sat behind me as I faced a wall with a purple abstract painting on it, usually covered in a fleece blanket, and talked openly about all the things that hurt. We followed a stream-of-consciousness style, letting my random thoughts take us in different directions, digging into the things I wanted to avoid, asking where they came from. Psychoanalysis is not just talking about what's bothering you, but discovering the roots of the problem. For me, we learned that a lot of my feelings of abandonment had to do with being sent away to a teen psych ward as a thirteen-year-old anorexic. A lot of my feelings about my self-worth and fitting in had to do with my mom and her ways of moving, what I'd learned as coping mechanisms from growing up around alcoholism. I was convinced that, if I talked about my ugly feelings and things you weren't supposed to talk about, that no one would love me. It took a lot of self-exploration to start to identify those feelings and shut them down. It's a process I'll never be done with.


Not getting swept down the river, Betsy likes to say (she's good with the metaphors). Not losing control. These are things I've had to learn. How to be present. How to be honest with myself. Therapy, and in particular psychoanalysis, is hard work. It can be exhausting. And, in my case, a financial and time investment. As I wrote some time back, you don't graduate therapy. The work is never really done. But, Betsy and I have come to a point where this phase of the work is complete. We switched from psychoanalysis a little over a year ago to psychotherapy, just before the pandemic hit. We went from two Zoom sessions a week to one when I just couldn't fit two hours in. And, since I started working three jobs, it's been a challenge to fit in even one session. It's felt more like a chore. When I was lamenting my lack of time, Betsy said, "Well, this feels like it might be a good time to stop." And it did feel that way. So, here we are.


I know that, as a bipolar woman who has experienced trauma, therapy will never be completed for me. I imagine that I will likely come back someday, when I need it. But, for now, today, things are looking pretty good, I have those sharpened tools in my toolbox, and I'm ready to go it on my own, with a pretty solid support system behind me. I hope that you, reader, find the help you need, and the wisdom to know when you're ready to move on, to walk on your own.

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