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About four years ago, a new patient came to me for a psychiatric consultation who felt stuck. He had been in treatment for his 15 years, even though the depression and anxiety that first prompted him to seek help had long since disappeared. Instead of him addressing issues related to his symptoms, he and his therapist discussed vacations, home renovations, and office frustrations. His therapist effectively became a valuable and especially supportive friend. Still, when I asked him if he was thinking about stopping treatment, he seemed hesitant and even anxious. “It’s baked into my life,” he told me.
Among those who can afford it, regular psychotherapy is often viewed as a lifelong project, like working out or going to the dentist.Research shows that while most therapy clients can evaluate treatment in months rather than years, a significant portion of current and former patients expect Treatment continues indefinitely.therapist or client Similarly, together celebrity and media outlet, supports the idea of going to therapy for a long stretch or when you feel good. I myself have seen the same thing with friends who are basically healthy and think that hiring a therapist is similar to hiring a physical trainer. The problem is that some of the most commonly sought psychotherapies are simply not designed for long-term use.
There are many different types of treatments, but they all have a common goal. It’s about feeling and functioning well enough to thrive on your own and eventually finish treatment. The outage doesn’t even have to be permanent. If you have been in treatment for a long time and are no longer in acute pain and have few worrisome symptoms, consider taking a break. You may be pleasantly surprised at how much you learn about yourself.
Treatment can be life-changing, both in the short and long term. Short-term therapy tends to focus on specific issues, such as depressed mood or social anxiety. In cognitive behavioral therapy, typically used for depression and anxiety disorders, clinicians help clients alleviate negative emotions by modifying distorted beliefs they have about themselves. Dialectical behavior therapy, commonly used to treat borderline personality disorder, teaches patients skills to manage strong emotions and helps improve mood and relationships. Both treatments usually last her less than a year. If you start to feel rusty or find upcoming life events particularly difficult, simply return to another short-term job. Termination is expected and normal.
Some types of therapy, such as psychodynamic therapy and psychoanalysis, are designed to last several years, but not forever. The primary goal of these treatments is much more ambitious than symptom relief. They aim to uncover the unconscious causes of suffering and change the client’s fundamental personality. At least one reputable study found that: long term treatment It is highly effective and superior to shorter-term treatments for people diagnosed with clinically significant mental illness.other paper There is less conclusive evidence regarding long-term treatment. Additionally, few studies have compared short-term and long-term treatments for patients with mild symptoms.
In fact, there is reason to believe that using talk therapy in the absence of acute symptoms may be harmful in some cases. In an environment where you’re literally paying people to talk about how they feel, focusing too much on yourself can increase anxiety, especially if it’s a substitute for concrete action. If your symptoms of neurosis or depression are relatively mild (meaning they don’t interfere with your daily life), you may want to spend less time in your therapist’s office and more time connecting with friends, hobbies, or volunteering. You might get more bang for your buck. Therapists are trained to use the tools they have learned for specific types of problems, and many of the finer points of daily life that cause stress are not included in the tools. For example, if you tell your therapist that you’re struggling to be effective at work, your therapist might decide to teach you stress-reduction techniques, but your co-workers or boss might want to give you more specific strategies to improve your performance. may be provided.
One of my childhood friends had parents who were psychoanalysts, and we went to weekly therapy appointments since we were little. Although he was a happy and energetic child, his parents wanted him and his sister to know themselves better so that they could cope with whatever adversity was thrown their way. My friend and his sister both grew up to be successful adults, but they were also very anxious and neurotic people. I imagine their parents would say that without the therapy their children would have been even worse off. After all, mental illness runs in their families. However, no substantial clinical evidence has been found to support this type of “preventive” psychotherapy.
Needless to say, being the first to begin treatment is a privilege. Treatment is not covered by many insurance plans, and a significant number of people who could benefit from treatment cannot afford it for any length of time.only 47 percent Percentage of Americans who received some form of treatment for a mental illness in 2021. In fact, federal estimates suggest that the U.S. is lacking thousands of mental health professionals, a gap that is likely to get worse. growing up In the next few years. Discontinuing treatment when you are ready opens up space for others who may need this rare service more than you.
I’m not saying that therapy leave should be taken lightly or that everyone has it. If you have a severe mental health disorder, such as major depression or bipolar disorder, you should discuss with your mental health provider whether ending treatment is appropriate for your individual situation. (Keep in mind that your therapist may not be ready to quit when you want to. Aside from the financial incentive to continue treatment, you may find yourself with an attractive, low-maintenance patient Breaking up isn’t that easy.) My rule of thumb is that you should: You may even consider pausing after six months of minimal or no disease symptoms. If you and your therapist agree that stopping is reasonable, a temporary break with a clear deadline is ideal. You can always switch back if you feel uncomfortable.
Psychiatrists do the same thing with psychiatric medications. For example, if I prescribe an antidepressant to a patient with depression, and then the symptoms have stabilized and become symptom-free for several years, I typically review the medication to determine if it is still necessary for the patient’s health. Consider weight loss. There is. I only do this for patients who have a low risk of recurrence, such as those who have only had one or two recurrences, rather than those who have had many recurrences in their lifetime. The risks of pausing treatment should be even lower. The great thing about therapy is that, unlike drugs, you learn new knowledge and skills that you can take with you when you leave therapy.
About a year after the patient and I first talked about ending treatment, I met him at a cafe. He told me that it took him 6 months to quit smoking, but he is better now. Perhaps you, like my patient, are daunted by the idea of quitting cold turkey. If this is the case, consider taking a break from treatment instead. This might be a great way to see how far you’ve come.