This article originally appeared on welldoing.org in November 2018: https://welldoing.org/article/what-is-it-like-to-get-a-new-therapist
I have been in therapy since 2000 and until last December had been seeing the same therapist, Alexis, first once and then twice a week for all of that time. Next Friday, it will be a year since Alexis told me that she unexpectedly had to bring forward her retirement - originally planned for September 2018 - due to difficult personal circumstances and that our last session before the Christmas break, six weeks later, would be our final one. Those six weeks were incredibly difficult for me, and as the anniversary of her announcement approaches, I have been reflecting on what our relationship meant to me, and how the year since her retirement has been.
After giving myself a few months in which to process and grieve for the end of my relationship with Alexis, I began seeing a new therapist, Sarah. She was recommended to me by Alexis, and I have been very lucky since I felt a positive connection with her from our very first session. She knows Alexis and she knows the history of my relationship with her, which something that we often discuss. They both trained at the same institution, and I can see certain similarities in their approach in our sessions. However, Sarah is of course very much her own person and I think from the very outset wanted our sessions to start from the basis of a common understanding that the therapeutic relationship between us would not replicate the relationship and experiences I had with Alexis. I think it was really important for that to be stated explicitly in our first session. It was something that I already knew, but it needed to be acknowledged on both sides. I have also been aware that I have made a concerted effort not to make direct comparisons between Sarah and Alexis. I want to build a new relationship, and need to remember that my relationship with Alexis was a unique one, at a unique stage in my life. Nonetheless, until this year, ‘psychotherapist’ to me effectively meant ‘Alexis’. Not least because I am now embarking on training potentially to become a psychotherapist myself, it is really interesting to have had this new experience, albeit a limited one so far, of a different model of a patient-psychotherapist relationship.
Due to the length of time for which I saw Alexis, it is difficult for me to untangle which aspects of our relationship were about a therapist - patient relationship more broadly and which were simply about the personal connection between the two of us. I suppose it doesn’t really matter. Yet when Alexis first told me she was retiring, I felt that perhaps it did. I have read a lot about the theory around how relationships with therapists ‘should’ work: the patient displaces and projects feelings onto the therapist, and the dynamics of other relationships are played out from the therapist’s couch.
When Alexis told me that she was retiring, I was devastated. As I often told her, Alexis was the one who saved me. If I hadn’t started seeing her all those years ago, I honestly don’t think I would be here today. Not surprisingly, I felt a huge sense of anxiety and above all loss at her impending retirement. However, I felt the need to couch my sadness in almost apologetic terms when I discussed it with her. I explained that I knew, from an intellectual point of view, that a great deal of the sense of attachment in a relationship with a therapist is due to those psychological processes of displacement and projection that develop over time. I think that ultimately I feared rejection. I worried that from her more detached and intellectual vantage point, Alexis would understand that my feelings were confused due to the psychological support that she had given me over the years. In the event, Alexis dismissed any rationalisation of my very real emotions. She told me that I was allowed to be sad, and should not be ashamed of what I ought to acknowledge as genuine feelings.
And I was sad. My relationship with Alexis has been the most significant one in my life so far, and it has given me so much. Firstly, it gave me the understanding that I have the capacity to build new and positive relationships. This took a long time to develop. Before it did, in any group including new people, I would stay close to the people I knew. While many of my friends expanded their social circle in their twenties, embracing new connections with friends of friends, I stuck resolutely to the people with whom I felt comfortable, not really getting beyond small talk with anyone else. If I ever thought about it, I told myself that I didn’t need any more friends. This was a relatively easy way to rationalise and manage my anxieties around building new relationships. Now, I regret missed opportunities, and also the fact that my negative perception of my own attributes and potential was so firmly entrenched. My relationship with Alexis challenged that perception. In its early stages, I was very resistant to analysing our relationship. It seemed to me to be something apart; it neither was nor was not confirmation of any ability to build connections and relationships with other people. However, the very fact that it existed in isolation from the distractions, uncertainties and distortions of the paraphernalia and circumstance of daily life eventually forced me to acknowledge that its coming into being could only be as a result of the engagement of the two participants in it, i.e. Alexis and me. While on some significant level it was one-sided – Alexis told me nothing of her personal life, nor of her own worries and fears – it remained nonetheless a two-way relationship that I believe had meaning for us both. This eventually gave me the confidence to be more open with friends, colleagues and acquaintances, and to believe that I could make connections with them. This has improved my life immeasurably, in that it has led to new and rewarding relationships, while at the same time strengthening those I already had.
The ending of my relationship with Alexis was incredibly difficult since she knew, and knows, more about me than anyone else. Over the years, I felt increasingly able to discuss almost anything with her, though we were both aware that there were certain, more challenging emotional areas that I was inclined to steer away from - something I now regret. Alexis was there for me at the most difficult points in my life, including two periods of significant depression. When I felt despairing or suicidal, I was able to discuss this with her in a way that I did not feel was possible with my family or friends. I felt that she had the emotional resilience to hear what I needed to say. She showed me great kindness and calm understanding. Alexis always genuinely listened to what I had to say, in the sense that I felt she took my concerns seriously. At the same time, she would never hesitate to challenge me, and it was precisely because she knew me so well that I was more wiling to listen to her than to other people. Not that we would always agree. A while before she retired, Alexis told me that she thought I was very oppositional. Inevitably I suppose, I disagreed. She also expressed her surprise that no one else had ever pointed this character trait out to me. I think this is indicative of the fact that very few people have ever seen as much of me and my feelings as Alexis did. Notwithstanding the fact that my relationships with friends are much more open and honest as a result of my therapy, I still very rarely have the kinds of conversations with them that I had with Alexis. On one hand this saddens me, though on the other I think it is an inevitable consequence of the pace and nature of modern life, with demanding jobs, scattered friendship groups and a whole host of other obstacles thrown in the path of opportunities for quality time and extended conversations. Alexis also challenged me to question the nature of some of the feelings I shared with her. Anger is an emotion with which I find it particularly difficult to engage and while I would frequently tell her that I was upset, or stressed, or in a state of panic, Alexis would often reflect these emotional experiences back to me as an expression of my anger. Although difficult to navigate, these conversations gave me a greater sense of ownership and control over my emotions, since they enabled me more clearly to identify their origins and how they were affecting me. With anger in particular, my discussions with Alexis helped me understand that it is an emotion that can be expressed and which in fact often needs to be.
When Alexis retired, I felt anxious about having to face a period of time without the support of regular therapy sessions. I had decided that I would take a few months away from therapy, to allow myself time to process the end of our relationship. While those months were extremely challenging, they were always going to be and it was right to give myself space to grieve. The fact that I was able to reflect on our relationship was a positive thing. I had worried that, left to my own devices, I would revert to the model of behaviour I had employed for so many years before therapy, a pattern of frantic activity and distraction techniques to avoid having to face up to difficult emotions. In the event, while I missed therapy and desperately missed Alexis, I was able to create time and space for self reflection. I also spent time writing, and exploring the various routes into psychotherapy that I might want to consider for the following academic year.
During those last few weeks with Alexis, we discussed how much had changed for me over the seventeen years I had been seeing her. I can still struggle with anxiety and depression, and in moments of greatest difficulty still have a tendency to feel that I cannot share my feelings with other people, and instead turn complex and negative emotions inwards. I still find it difficult to understand the origins of my negative and at times masochistic thought processes. Alexis reassured me that it is perhaps enough to be aware of them, which in turn is certainly more healthy than the alternative strategy of trying to keep them at bay. She described a possible relationship with difficult emotions as walking beside them. The emotions are there, alongside me. I am not ignoring them, but I have accepted that they cannot be continually indulged or examined. At the right time, they can be taken down and explored, and shared with those who care about me. I have found this approach extremely helpful over the last year, not least in terms of my feelings of sadness around the end of my relationship with Alexis. Not that she viewed its ending in quite the same, definitive way that I did. It was clear from our discussions that she regretted the unexpectedly abrupt way in which our sessions came to an end, which gave us very little time to process it. However, she also stated her conviction that something that has come into being cannot then simply cease to exist. She was reflecting on the end of our relationship and I think her belief that it could continue to have a lasting legacy, albeit our sessions were coming to an end. While, in the midst of my grief, I found it hard to engage with this idea, the last twelve months, how I have coped, survived, taken forward steps, carried Alexis’ words and so many of the things that I learned in our sessions with me, have proved that she was right to believe that the impact of our relationship would be long lasting. I am still very, very sad, and I still miss both Alexis and the time we spent together. However, I am surviving, more than surviving, have begun a positive journey with my new therapist, and have taken the first steps on a new path to my own possible career as a psychotherapist. What I knew during my time with Alexis has remained clear: there have been fundamental shifts in my emotional make-up, thanks to my experience of therapy. I will not and in fact cannot return to the person I was before my sessions with Alexis began, since that person no longer exists. Traces of her remain, but I have benefited from a huge expansion in my understanding of myself and my emotions. Although I may no longer be seeing Alexis, the progress we made together over those seventeen years remains.
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