By RICHARD A. FRIEDMAN, M.D.

If you think it's hard to end a relationship with a lover or spouse,
try breaking up with your psychotherapist.

A writer friend of mine recently tried and found it surprisingly
difficult. Several months after landing a book contract, she realized
she was in trouble.

"I was completely paralyzed and couldn't write," she said, as I
recall. "I had to do something right away, so I decided to get myself
into psychotherapy."

What began with a simple case of writer's block turned into seven
years of intensive therapy.

Over all, she found the therapy very helpful. She finished a second
novel and felt that her relationship with her husband was stronger.
When she broached the topic of ending treatment, her therapist
strongly resisted, which upset the patient. "Why do I need therapy,"
she wanted to know, "if I'm feeling good?"

Millions of Americans are in psychotherapy, and my friend's experience
brings up two related, perplexing questions. How do you know when you
are healthy enough to say goodbye to your therapist? And how should a
therapist handle it?

With rare exceptions, the ultimate aim of all good psychotherapists
is, well, to make themselves obsolete. After all, whatever drove you
to therapy in the first place - depression, anxiety, relationship
problems, you name it - the common goal of treatment is to feel and
function better independent of your therapist.

To put it bluntly, good therapy is supposed to come to an end.

But when? And how is the patient to know? Is the criterion for
termination "cure" or is it just feeling well enough to be able to
call it a day and live with the inevitable limitations and problems we
all have?

The term "cure," I think, is illusory - even undesirable - because
there will always be problems to repair. Having no problems is an
unrealistic goal. It's more important for patients to be able to deal
with their problems and to handle adversity when it inevitably arises.

Still, even when patients feel that they have accomplished something
important in therapy and feel "good enough," it is not always easy to
say goodbye to a therapist.

Not long ago, I evaluated a successful lawyer who had been in
psychotherapy for nine years. He had entered therapy, he told me,
because he lacked a sense of direction and had no intimate
relationships. But for six or seven years, he had felt that he and his
therapist were just wasting their time. Therapy had become a routine,
like going to the gym.

"It's not that anything bad has happened," he said. "It's that nothing
is happening."

This was no longer psychotherapy, but an expensive form of chatting.
So why did he stay with it? In part, I think, because therapy is
essentially an unequal relationship. Patients tend to be dependent on
their therapists. Even if the therapy is problematic or unsatisfying,
that might be preferable to giving it up altogether or starting all
over again with an unknown therapist.

Beyond that, patients often become stuck in therapy for the very
reason that they started it. For example, a dependent patient cannot
leave his therapist; a masochistic patient suffers silently in
treatment with a withholding therapist; a narcissistic patient eager
to be liked fears challenging his therapist, and so on.

Of course, you may ask why therapists in such cases do not call a
timeout and question whether the treatment is stalled or isn't
working. I can think of several reasons.

To start with, therapists are generally an enthusiastic bunch who can
always identify new issues for you to work on. Then, of course, there
is an unspoken motive: therapists have an inherent financial interest
in keeping their patients in treatment.

And therapists have unmet emotional needs just like everyone else,
which certain patients satisfy. Therapists may find some patients so
interesting, exciting or fun that they have a hard time letting go of
them.

So the best way to answer the question, "Am I done with therapy?" is
to confront it head on. Periodically take stock of your progress and
ask your therapist for direct feedback.

How close are you to reaching your goals? How much better do you feel?
Are your relationships and work more satisfying? You can even ask
close friends or your partner whether they see any change.

If you think you are better and are contemplating ending treatment but
the therapist disagrees, it is time for an independent consultation.
Indeed, after a consultation, my writer friend terminated her therapy
and has no regrets about it.

The lawyer finally mustered the courage to tell his therapist that
although he enjoyed talking with her, he really felt that the time had
come to stop. To his surprise, she agreed.

If, unlike those two, you still cannot decide to stay or leave,
consider an experiment. Take a break from therapy for a few months and
see what life is like without it.

That way, you'll have a chance to gauge the effects of therapy without
actually being in it (and paying for it). Remember, you can always go
back.

Richard A. Friedman is a professor of psychiatry at Weill Cornell
Medical College.

x-no-archive: yes

% wrote:

"Janithor" <Janithor@comcast.net> wrote in message
news:4726CBE8.9030202@comcast.net...

x-no-archive: yes

% wrote:

"Teilhard Knight" <teilhk@privacy.net> wrote in message
news:pan.2007.10.30.06.06.45.719035@privacy.net...

On Mon, 29 Oct 2007 22:56:46 -0700, % wrote:

pez dispenser

Your nose is red.

Teilhard.

so is your penis , leave it alone

me odias

oh ***** , here goes the babel fish boys

ja ja ja

By RICHARD A. FRIEDMAN, M.D.

If you think it's hard to end a relationship with a lover or spouse,
try breaking up with your psychotherapist.

A writer friend of mine recently tried and found it surprisingly
difficult. Several months after landing a book contract, she realized
she was in trouble.

"I was completely paralyzed and couldn't write," she said, as I
recall. "I had to do something right away, so I decided to get myself
into psychotherapy."

What began with a simple case of writer's block turned into seven
years of intensive therapy.

Over all, she found the therapy very helpful. She finished a second
novel and felt that her relationship with her husband was stronger.
When she broached the topic of ending treatment, her therapist
strongly resisted, which upset the patient. "Why do I need therapy,"
she wanted to know, "if I'm feeling good?"

Millions of Americans are in psychotherapy, and my friend's experience
brings up two related, perplexing questions. How do you know when you
are healthy enough to say goodbye to your therapist? And how should a
therapist handle it?

With rare exceptions, the ultimate aim of all good psychotherapists
is, well, to make themselves obsolete. After all, whatever drove you
to therapy in the first place - depression, anxiety, relationship
problems, you name it - the common goal of treatment is to feel and
function better independent of your therapist.

To put it bluntly, good therapy is supposed to come to an end.

But when? And how is the patient to know? Is the criterion for
termination "cure" or is it just feeling well enough to be able to
call it a day and live with the inevitable limitations and problems we
all have?

The term "cure," I think, is illusory - even undesirable - because
there will always be problems to repair. Having no problems is an
unrealistic goal. It's more important for patients to be able to deal
with their problems and to handle adversity when it inevitably arises.

Still, even when patients feel that they have accomplished something
important in therapy and feel "good enough," it is not always easy to
say goodbye to a therapist.

Not long ago, I evaluated a successful lawyer who had been in
psychotherapy for nine years. He had entered therapy, he told me,
because he lacked a sense of direction and had no intimate
relationships. But for six or seven years, he had felt that he and his
therapist were just wasting their time. Therapy had become a routine,
like going to the gym.

"It's not that anything bad has happened," he said. "It's that nothing
is happening."

This was no longer psychotherapy, but an expensive form of chatting.
So why did he stay with it? In part, I think, because therapy is
essentially an unequal relationship. Patients tend to be dependent on
their therapists. Even if the therapy is problematic or unsatisfying,
that might be preferable to giving it up altogether or starting all
over again with an unknown therapist.

Beyond that, patients often become stuck in therapy for the very
reason that they started it. For example, a dependent patient cannot
leave his therapist; a masochistic patient suffers silently in
treatment with a withholding therapist; a narcissistic patient eager
to be liked fears challenging his therapist, and so on.

Of course, you may ask why therapists in such cases do not call a
timeout and question whether the treatment is stalled or isn't
working. I can think of several reasons.

To start with, therapists are generally an enthusiastic bunch who can
always identify new issues for you to work on. Then, of course, there
is an unspoken motive: therapists have an inherent financial interest
in keeping their patients in treatment.

And therapists have unmet emotional needs just like everyone else,
which certain patients satisfy. Therapists may find some patients so
interesting, exciting or fun that they have a hard time letting go of
them.

So the best way to answer the question, "Am I done with therapy?" is
to confront it head on. Periodically take stock of your progress and
ask your therapist for direct feedback.

How close are you to reaching your goals? How much better do you feel?
Are your relationships and work more satisfying? You can even ask
close friends or your partner whether they see any change.

If you think you are better and are contemplating ending treatment but
the therapist disagrees, it is time for an independent consultation.
Indeed, after a consultation, my writer friend terminated her therapy
and has no regrets about it.

The lawyer finally mustered the courage to tell his therapist that
although he enjoyed talking with her, he really felt that the time had
come to stop. To his surprise, she agreed.

If, unlike those two, you still cannot decide to stay or leave,
consider an experiment. Take a break from therapy for a few months and
see what life is like without it.

That way, you'll have a chance to gauge the effects of therapy without
actually being in it (and paying for it). Remember, you can always go
back.

Richard A. Friedman is a professor of psychiatry at Weill Cornell
Medical College.