The Termination, Part III

So Monday arrived. The actual FINAL session with Zooey. And I was as well-prepared as I think I possibly could have been. I kept repeating self-affirmations and positive mantras over and over in my head on the way to session. I went in there telling myself that I had control over how I felt about this goodbye. I wanted to walk out of there feeling as much peace and closure as possible under such shit circumstances.

When I first got there, I sat down and thanked her for agreeing to see me. She suggested we clarify the referral issue first before talking about other things, so we spent a few minutes discussing possible referrals. I mostly think this was just so she could feel better about completely abandoning me in the middle of intensive treatment, but whatever. I was willing to play along.

Then it was my turn. And I took the rest of those 45 minutes to get out as much of my thoughts and feelings as possible. Here is the (very long) letter I read to her:

“Dear Zooey

I requested this session because I knew if I didn’t, I would probably regret it forever. But I was admittedly surprised that you said yes, and then immediately panicked about how I would actually use this time. But I’ve thought about it, and I know that what I need is to find as much peace as possible with this situation.

I agonized so much over how I could achieve that. I know I don’t want to spend 45 minutes hashing out the gory details of what went wrong. But I also don’t want to be inauthentic. So although my main focus is to express gratitude and to celebrate the relationship we’ve built and the work we’ve done together, there are a few things that I need to be honest about upfront.

Firstly, I am so hurt that you brought [Wife] and I in here under the pretense that we’d be “discussing insurance issues” only to almost immediately announce that you were referring me out. I’m also angry that you were vague and unclear about it at first, saying that you thought “switching to [other] provider was a good idea” rather than just being explicitly clear that this was a non-negotiable decision you’d already made. I’m also confused that although you said you would have terminated over the insurance issues alone, you still brought up all the reasons why you didn’t think we should continue working together anyway. I was shocked to hear you say that you didn’t think I was getting better and that new problems were coming up. Of course new problems are coming up. I think that’s what happens when you do this kind of work. But I want to acknowledge that we’ve also worked through some really hard stuff and overall, I do believe that I have gotten stronger and healthier and certainly more skillful.

I know things have been difficult recently, specifically in our relationship. I’m not exactly sure when it started, but it’s painfully obvious that our communication has deteriorated. On my end, I think it was mainly out of confusion and fear. I was trying to balance the openness and vulnerability required to make therapy effective with the need to keep things contained and safe. There are always so many things I wanted to share with you – letters I’d written, or entire conversations I’d pre-rehearsed – but once I sat down in front of you, I was so afraid of switching or dissociating or experiencing some sort of flashback or body memory that I literally could not get the words out of my mouth.

I was also specifically frightened by your statement that we’d “been through hell together and both came out a little beaten up for it” because that is almost verbatim what my biological mother would say to me. Amidst all of her abuse and cruelty and shuttling me off to various therapists, doctors, and hospitals, she’d always make a point to make sure I knew she was “in this too.” But it never felt like she was in it with me. It felt like she used my struggles and suffering to procure sympathy and to lament about how difficult it was to care so much about a person who was so devastatingly ill. She always made it about her.

When you asked me if I felt that you were a part of this and invested in it, I panicked and I lied. The truth is that I have always felt your presence along this journey. I have always believed you were invested in me and in my treatment. But in that moment, the fear of enmeshment was absolutely suffocating. The transference was so strong, in fact, that at moments I thought my mother was actually in the room. And I wanted to hurt her. I wanted to say awful things that would make her feel terrible. But instead, I hurt you and I said awful things to you. Then I was taken aback at how personally you seemed to take it. And then when I realized I had actually hurt you, I just shame-spiraled even further downward. By that point, I just did not know how to recover the session.

I’d like to think you were being honest when you said you would terminate over the insurance alone, but I’m not sure. I know I was an absolute wreck on Thursday, but in a way, I didn’t even recognize you. You seemed so cold and distant and just disconnected from yourself. I can’t say I blame you given all that has happened, but I know we’re both better than that interaction.

I’ve really thought about it and I think that on some level, we both knew that we’d gone as far as we could together. But maybe we were also both holding on so strongly because we really wanted this to work. I know I did. And I also know that I would have probably never had the strength to walk away voluntarily. Perhaps it’s similar for you. As much as it sucks, maybe this insurance fiasco is the push we needed to finally face the truth. Maybe it provides the chance to allow us to move on and let go of the therapeutic relationship.

I came here today because I don’t want last week’s disaster to be how this ends. I don’t want to remember you as the therapist that abruptly abandoned me out of helplessness, anger, and frustration and I don’t want you to remember me as the impossibly difficult patient who not only ended up putting you in an awful insurance situation, but then was totally ungrateful for all of the time and energy you put into her care. I don’t want you to regret agreeing to treat me. And I don’t want either of us to be a black mark in each other’s story.

That being said, this is still a very difficult and painful experience for me. You seemed shocked and offended at our hostility towards you on Thursday, but I’m honestly so confused that you would have expected us not to be hostile under the circumstances. I don’t understand why you didn’t expect that I’d be completely devastated by losing you as my therapist. I have spent endless time in and out of session expressing an intense fear of this very thing. Of course I would be hysterical and scared and angry and a total mess.

I know that this will eventually be okay for me and for the system. I know that time heals loss and that grief is a unique and complicated process. But right now, it is awful. Right now, I don’t know what to do without you. I have seen you twice a week for ten months. What has helped this therapy work is ultimately what will make it so difficult to lose it.  I think about you every single day. I incorporate small things into my daily life and routine to remind myself that I have you and that you support me. I have a picture of you taped to my wall and your business card in my wallet and on my refrigerator. I’ve talked to you on the phone from every room in my apartment, including while curled up in bed or laying on the bathroom floor in tears. Every time I go to yoga, I dedicate my practice to us and to the work we’re doing together. I’ve spent a crazy amount of time on trains and platforms on my way to or from sessions, listening to a special playlist I made and processing our conversations. So much of what anchors me to my life and to this City is you and this treatment. I am scared of what my life will look like without you as my therapist. I am terrified to start again. I am even more terrified to start again and lose that person as well.

But the truth is that even a year ago, something like this would have totally destroyed me. I would have just wrapped myself up in a shame blanket and pushed the entire world away. But I didn’t do that. I called the therapist you recommended. I called my surrogate “Mom”. I called my best friend. I called Justin. I called the Hill Center to talk to a counselor I really trusted and respected. I texted some of my other close friends and posted in online support forums. I reached out to the people that care about me because this relationship and this therapy has taught me that there are people that care about me and that I am worth being cared about.

I am so tremendously grateful for you and for the work that we have done together. I have watched you work so hard to learn and adapt and adjust to my ever changing needs. I am very aware that you went above and beyond to help me and to ensure I got the best treatment possible. You listened as I unfolded this horrific story of abuse and torture. You never once doubted me or challenged the validity of my words. You sat with me through some of the most agonizing re-experiencing events of my life, which I know must have been awful for you as well. You tried virtually everything to help keep me stable, safe, and alive all while offering endless empathy and also giving me some room to assert myself. You stuck by me and fought for me in ways no treatment provider has ever done.

And most importantly, you saw me. You saw us. You provided a safe enough space for our system to begin to reveal itself. You interacted with these parts, working with them individually while also trying to balance the needs of the others. You were the first person to see us and hear us and provide for us. Losing you is a huge loss for all of us, but you have given us the most beautiful gift in allowing us all to be seen and heard and known.  It will be scary and take time to open up and reveal ourselves to a new therapist, but I also know that we will never go back into hiding.

I once told you that I thought of the therapeutic relationship as a cauldron – that if we forged a solid enough container together, it wouldn’t matter how hot or toxic the liquid was that I poured into it. I still believe that’s true.  But I can see now that sometimes you cannot predict the strength required to contain certain things. I’d like to think that you and I built a cauldron to get me this far, and now you are passing me to someone with more experience and skills to forge an even stronger vessel that can hold what is left to be worked through.

I wouldn’t have been ready for that kind of therapy 10 months ago. As resistant as I feel to starting over with a new therapist, I have to admit I am also strangely excited about the idea of working with someone who really understands my specific history and symptoms. I am cautiously optimistic that I might actually be able to manage this system and have a somewhat normal and calm life that isn’t marked by blank space or the time in between crises. And I know that I wouldn’t even have this opportunity if you hadn’t helped me get this far.

Before I even met you, when I just pulled up your website and made that first call to request an appointment, I knew that you would change my life. I knew you were the therapist I would choose to re-start this work. But I am sad that we couldn’t complete this journey together. I honestly thought that I would know you for the rest of my life. I thought I would share so many more good and bad moments with you. I thought that if I ever had children, my children would know you. I thought you would be my therapist for many more years.

I suppose that was naïve, but I hope that this isn’t the end for us. I know that our therapeutic work has been completed, but I do hope that I can still have you in my life somehow, tangentially. I know that you know that both my former therapists are a small part of my life. In 11 years, I have never once reached out to either of them for clinical or therapeutic reasons. And I went a very long time after ending treatment before re-connecting with them to give myself time to adjust to the end of the therapeutic relationship. I know things are intense and raw right now, and that this is perhaps a lot to request from you, but I do still want to ask that you consider keeping space open for us to stay connected at some point, in some manner. I want to be able to tell you when I graduate or get my [health program] license or go on to Graduate school or run a marathon or whatever.  I know this is tricky and everyone has their own set of values on this type of thing, but I wouldn’t be me if I didn’t put it out there and at least ask.

Regardless, you have been such a gift to me. I have learned so much about myself in these last 10 months and have started to let go of some of the shame and guilt and self-hatred that I was holding onto so fiercely. I know I still have a long way to go, but you have really allowed me to understand that I am not crazy, I am not a liar, I did not deserve to be hurt the way that I was, and I am capable of being more than just an abuse victim. In some ways, the world seems bigger and brighter to me now. I feel like I can take deeper breaths because part of the weight has begun lifting from my chest.  I have so much more hope than I have ever had. And I truly believe that I will be okay.

So thank you, Zooey. Thank you for believing me. Thank you for bearing witness to my story. Thank you for being someone I could trust and rely on. Thank you for fighting for me. And thank you for not giving up on me. Because I know that this is not you giving up on me – this is you giving me even more. I will always think of you and you will always be in my heart.

I love you,

Andi”

After I read that, we didn’t really talk about it much. I’m not sure she even knew how to respond and to be frank, I didn’t want to hear her response. I was too afraid of what she would say and I could not bear any more disappointments in that moment.

So I proceeded to give her holiday gifts from the system. A drawing from Anna (a child part):

Anna’s drawing

As well as a card and some candy from River, a book of poetry and a CD (of songs we listened to on the train to and from therapy) from Julia, and a sculpture from me. I made it several years ago when I first started to (sorta) realize that there were different “parts” of me. I’d shown it to her early in treatment and she kept in on her desk the entire time I saw her. I took it back the day she terminated, but I felt that since she was the first therapist to really understand the DID and “see” all the different parts, it was only appropriate that she keep it.

Then session was over. Before I left, I specifically asked if it was okay to reach out to her in the future. She said she’d like to see me get set up with a referral first, but that her answer was yes. I don’t know what, exactly, that means (which is, of course, agonizing) but it’s soothing to know she’s not TOTALLY gone from my life forever. I CAN reach out at some point if I want/need to feel connected to her. Only time will tell if that should ever occur.

And then in a final act of courage and vulnerability, I asked if I could hug her (we had never hugged before). She said yes. I gave her a long, sincere hug. She said that she really did wish the best for me…for all of us (the system). I thanked her again for everything, took a very deep breath, looked at her one last time, and then walked out.

And just like that, it was over.