It’s a tale as old as time—a therapist schedules a new client, completes the intake, has a few great sessions, and POOF! They’re gone. They disappear off the face of the earth without notice, never to be heard from again. A term referred to as “ghosting" is when someone leaves a relationship without notice or a goodbye. It is all too common in the dating world and happens pretty often in the therapy world as well. It can be so disappointing for us therapists to not see the completed puzzle or the ending to your story, but the empathy part of us understands how scary vulnerability can be.
For the Client:
First there needs to be some self-reflection.
Why did I choose to not return for my next scheduled appointment with my therapist? There may be times where that therapist actually wasn’t a good fit for you. Unfortunately, not every shoe fits so you may need to try another shoe on to find the perfect match. If you found yourself dreading their therapy style or demeanor, whether it is too confrontational or lacking structure, it may just be an issue of clashing personalities and that is okay. You are allowed to decide the type of people you spend time with and prioritize in your life.
Does this scenario happen in multiple areas of my life? Have I no-showed for previous therapists, doctors, or dates before without an legitimate explanation? If so, there may be bigger issues of confrontation anxiety and avoidance at hand. Read on to the therapist section.
Was the emotional discomfort that led me to “ghost” actually progress? It can be overwhelming to experience emotions or talk about past traumas out in the open when we spend so much time suppressing those thoughts in our regular life. As uncomfortable as it is, we need to address these big issues and give them a voice so we can experience less shame that accompanies them in the long run. Knowing progress can be disguised as emotional discomfort helps us acknowledge that discomfort can be strength and growth in a positive direction.
Did I just get to a point where I was feeling better and didn’t feel the need to go back? That is okay too! Often times, therapists recognize the need to go deeper in session and maintain consistency in appointments so clients don’t experience a huge drop-off in emotion management and coping skills when life gets hard again. Clients do not usually have that insight, saying to themselves, "Cool! I feel better so I don't need to keep that next appointment!" Sometimes even one session of feeling heard feels like enough to get them back on their feet short-term so it is okay to re-engage in therapy when life knocks you down later. Other times, therapy happens in stages. We begin therapy with certain goals in mind that seem pretty surface-level, like creating positive habits or reframing negative thoughts to healthier perspectives. Then after meeting those goals and being discharged, clients may realize they have more work to do after testing out their new skills. Deeper work. Then we set up another session to determine the next stage of therapy.
Did I ghost my therapist before our first meeting? What does that say about my readiness to be vulnerable and make changes for the better? There is also the likelihood that a client just isn’t ready to take the plunge like they thought they were. Maybe they need to experience “rock bottom” to recognize the impact of their mental health and they just haven’t reached their low yet. On the same note, change is scary! Even if we know our mental health is struggling, it may feel consistent or comfortable compared to the uncertainty of making changes.
For the Therapist:
Be aware that avoidance and confrontation anxiety may be crippling for anyone based on their histories. Many clients who have emotional trauma histories may avoid anything that includes emotional discomfort. And what is more uncomfortable than experiencing the disappointment of cancelling an appointment or breaking their word? It can be daunting for some clients, especially the people pleasers, to even imagine what they would say to a therapist to end their treatment. It is our job to be understanding and compassionate, meeting every client where they are.
That being said, we have the right to decline appointments or rescheduling as well. It stinks that we have all been burned, and I know we all have. We set aside time to see a client and they no-show without a single bit of closure. It can be emotional for us to not see a client through to discharge. Sometimes we feel like we’ve failed or like we didn’t give them enough. You do not have to take it personally. It is okay to have those feelings, to recognize we aren’t responsible for client’s behaviors, and to see that we are allowed to have boundaries on who/when we reschedule. If we are continuously no-showed by the same person, we are allowed to recognize our time is valuable and can be better used to help someone else.
This may need to be a moment of self-reflection for us too. Every therapist's style is different. Some people really connect to us and others do not. If you find yourself in a position of frequent ghosting experiences, it might be worth it to review your demeanor, consult with trusted colleagues to gain an objective view, and refine your therapeutic style. Perhaps it is as simple as building more rapport on the shallow end of the pool before heading to the diving board in the 12-foot!
Options for the client who wants to re-establish therapy:
Reach out! Call. Text. Email. Message in a bottle. Send a carrier pigeon. Who cares! The likelihood is that your therapist will just be happy you are reaching out to become a healthier, happier you. No explanations required! It is in our job description to empathize with you and understand your needs, which may have been different when you ghosted than the present moment. Trust me, us therapists have plenty experience in handling clients who ghost us gracefully and without judgment, so don’t be afraid to contact us.
If your therapist wasn’t the right fit, it may be worth it to reach out to friends and family to get their input and a potential referral. Perhaps they have been in therapy before and may have a better idea of who may fit better for your personality style. If you are feeling brave, you can also contact the therapist you ghosted with a simple message of, “I recognize I ended therapy abruptly but I don’t know if you were the right fit for me. Do you recommend anyone who is more (place adjective here) that you could refer me to?” Most of us therapists are connected within the therapeutic community, so we probably do and we would be happy to help. Our goal is to get you to the place where you feel better, whether that is with our help or the help of a trusted colleague. If the therapist responds defensively, no need to contact them again or respond—that person may need to do a little work on themselves too.
Whatever your route, dig into your courage and find someone who can help you. We can't do this alone.