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Therapy: Does It Ever End?

When it comes to therapy, when is it enough?

WebMD Feature

Feel like you've spent as much time with Shrinky as Woody Allen has? Wondering if you're ever going to get off the proverbial couch? Contrary to what you might think, therapists don't see their patients as lifelong meal tickets.

"In the course of treatment, you obviously touch on a lot of issues," says Leonard Tuzman, DSW, CSW, director of social work services at Hillside Hospital, a part of the North Shore-Long Island Jewish Health System in New York. "You could continue to work ad nauseum on all those issues, but at some point, patients need to take what they've learned in therapy out into the community. A therapist shouldn't foster lifelong dependency."

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"The job of therapy is to make the therapist expendable," agrees Joseph Napoli, MD, associate chief of psychiatry at Englewood Hospital and Medical Center in Englewood, New Jersey. Just as you grow up and leave your parents, says Napoli, so should you be developing the necessary tools to leave your therapist and live your own life.

How Long Is Long Enough?

Just how long does that take though? That depends on what brought you to the therapist's office in the first place, and what type of therapy you've been receiving. Cognitive behavioral therapy, for example, is designed to achieve specific goals, says Napoli. If you're afraid to drive, then a number of sessions -- perhaps 10 to 20 -- are agreed upon at the beginning of therapy and the problem is addressed through a combination of talk therapy, relaxation techniques, and exercises designed to get you back in the car. Once your symptoms are gone, so is the therapist.

Therapy that is more self-exploratory -- that examines how you got to be who you are today and what effect that is having on your life -- will be more in-depth and, as a result, last longer, says Napoli. "As a therapist, you want to see that the patient is approaching his present circumstances as an adult ... that he has learned to look at his behavior and understand its meaning, and can do things to change the actions and circumstances that may have brought him to therapy in the first place."

But even long-term therapy usually comes to an end, whether that takes a year, or two, or more. If you and your therapist have a good relationship, deciding to end it is not a one-way street -- on either end. "This isn't something either person should decide on his own," says Norman Rosenthal, MD, clinical professor of psychiatry at Georgetown University in Washington, and author of The Emotional Revolution: How the New Science of Feeling Can Transform Your Life. "It's a decision that's made in collaboration."

If you're thinking of leaving therapy, says Rosenthal, ask yourself why: Are you not getting much out of it anymore? Or, on the other hand, have you accomplished what you set out to do? Do you feel that the world and your relationships in it will be manageable on your own? "The messages will come from within," says Rosenthal. "Listen to them."

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