I'm probably going out on a limb saying this, but I don't really like autumn in Buenos Aires. Fewer daylight hours, the damp, and the watery sunshine remind me too much of the English winters I was always so desperate to escape from. Plus the falling leaves really don't help with the dog poo problem. But probably most of all, it makes me think of endings. The end of the summer, the end of the year, the new school year looming ahead when I was a child.
But before I send us all into a melancholic spiral, what I actually wanted to share today is that in my work, I'm lucky enough to partake in many many happy endings. Often my clients come to me in an autumn-like period of their lives. Maybe they have suffered a loss. Maybe things around them are changing or coming to an end, and they are faced with a dilemma. More often than not, all they can see are the dying leaves and the bare branches. They can't see where the new, fresh, green shoots will grow yet. That's my job.
Last week one of my clients was chatting happily about her week at work. It had been stressful, and less than six months ago it would have meant panic attacks, sleepless nights, uncontrollable angry outbursts at co-workers and random strangers, and a great deal of pain and suffering.
Watching her now I start to have the feeling that she's ready to begin the process of leaving therapy. I start to see greenery, something new, something fresh. I seize the opportunity and say "You seem really good". She thinks about it for a moment, smiles, and then answers "I am". Emboldened, I continue, "Do you remember when we first met, I said that we would work together so that you have more resources, and that once you can use them on your own we'd start seeing each other every two weeks, then every three, and then you'd eventually forget who I am because you won't need me anymore. I think we could try skipping next week's session. What do you think?". Her eyes fill with tears and she tells me that she feels humbled that I, the supposed expert, think she's doing well. I tell her that she's the expert when it comes to her. She agrees that we could try it and I give her the homework that I always give to make missing a session for the first time easier.
Watching a person get better and leave me is the most wonderful part of my work. And because I love it so much, I always make sure that right from the beginning I really pay attention to creating the correct conditions for a positive exit. I tell my clients in the first sessions that therapy has a beginning, a middle and an end. In the beginning we decide what we want to change. In the middle we make the changes. And at the end we enter into a period of checking and monitoring how the change is holding up, and this is the beginning of the end.
I always state my ethical position: I don't think it's a good thing for my clients to depend on me. When I work with a client we create resources together and as soon as they're ready to use them alone I start to reduce the frequency of the sessions. That way, I not only get to accompany them through the autumnal loss and the despair of winter, but I also get to enjoy the new shoots, the excitement and the promise of something new and different. I get to help them celebrate what they achieved. Hopefully I can prevent a relapse. We can say goodbye in a way that honours the intimacy and trust that we shared. But most importantly, they leave with something new, that they can use without me so that they can find their own happy ending.
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