My worst nightmare is coming true all over again

I just want to wake up from this nightmare. My T told me yesterday that she’s leaving the program where she works that I attend. She got a promotion and she’s going to go work up at the main hospital. I’m happy for her, but I’m also devastated.

EVERY single year since I’ve started therapy, my therapist has left me or I have had to leave them at this time of year. 4 years, 4 therapists, all the same result. And this time around, T kept ASSURING me when I said it was the time of year again when my T always abandons me, that she wasn’t going anywhere. To her credit, she didn’t know this promotion was coming, she was kind of just nominated for it without her knowledge. But still...I can’t imagine anything that could hurt worse. My abandonment trauma is getting kicked up hardcore right now.

T told me yesterday that in her 13 years working at the program and out of the 100s of clients that she has seen, that I’ve been one of her favorite clients to work with. She said that most of her doesn’t want to leave the program and I’m one of the main reasons why, but that she has to because she needs money to support her daughters, as she’s a single mom, and that she wouldn’t be a proper role model unless she took the opportunity to advance her career. I get it. But it hurts so much. It almost hurts more knowing that she felt so close to me. I knew I felt really close to her, but I assumed it was a one way thing.

She said that I’ll still be able to contact her via email and stuff after she leaves, which will be July 11th, but that our relationship will have to change and she can’t be my therapist anymore. She said she’ll leave the door open where if she opens a private practice some day, she would want to see me. She said the other therapists, one of who I will be working with after she leaves, all have iPhones and can FaceTime her, so if I start to spiral out, I better bet that she’ll be FaceTiming in and kicking my butt back into shape, because she’s not going to allow that to happen. I’d like to think this is true and that she’s still going to be there for me, she suggested like a mentor, but something in me tells me she’s going to leave, get busy in her new job, and forget about me. That’s how it always goes. We’ll drift apart and I won’t have her anymore, and I’m going to spiral out right at the wrong time. She helped me so much and helped me go from the point of such instability where I had just attempted suicide, to a point in my life where I am going back to medical school on July 30th. I needed her to be there for me when I go back to school and now she can’t be there like I need her to be. She can be there superficially, but not as my therapist.

I can’t handle this right now. I just broke up with my boyfriend yesterday and I am moving out on July 1st and everything else in my life is unstable, and she was supposed to be the one constant, but now even she is leaving me. I want to do dramatic and self-destructive things so that she’ll be concerned and stay, but that’s not even logical and I know it. She’s not going to stay no matter how much I self-destruct, and she will only get upset with me for self-destructing and it will make it hard for both of us. But I just feel like giving up. I feel defeated by life. My physical health has been declining recently and I’m rapidly losing weight and I’m malnourished and I can’t eat anything because I’m dealing with extreme chronic nausea. I feel like my whole life is falling apart and I just want my T to be there for me through it. Right now I just want to curl up in a ball in her office and refuse to leave. I want to cling and not let this happen. I can’t accept that this is my reality. This has to be some kind of sick joke or a nightmare that I just haven’t woken up from.

The only positive part of the day yesterday was that after I left, that afternoon I was emailing back and forth with T. Earlier that day, I had told her how my (now ex) boyfriend had texted me that me losing her was like Simba losing Mufasa and made this whole analogy. We both laughed hysterically at that and how cheesy it was and then she goes “you know, now I’m going to call you Simba...” and I was like “omg, well only if I can call you Mufasa.” And she agreed that I could, and then when I left she was like “it’s going to be okay. I promise.” And I said “Hakuna Matata, right?” And we laughed. And then when we were emailing back and forth we were making Lion king references and she joked that my life is like a Disney dream. I said “yeah, well, we all know that Disney movies do have those depressing undertones...sooo...yeah, my life is JUST like a Disney movie!” She goes “see how great you are at reframing now!” That made my heart happy and sad at the same time. I enjoyed it but I also feared that those moments are soon to come to an end.

She said she would call me during her lunch today. I already miss her so much and she hasn’t even gone anywhere. I’m in so much pain and I just want her to fix it but she can’t. And I feel selfish for not being happy for her. I hate this so much.

Your post is full of insight and beautifully written. I think that in some respects, your relationship with your T is an ideal that many of us hold for our own work with a T.

Is it possible to savor the fact that she has given you such strong signals of her respect -- her love-- for you? Could that help stop the slide into abandonment patterns that you fear?

Thanks for posting this here. While your pain is palpable, I can see how much you have grown as a result of your work together and nobody can ever take that away.

I wish I could hold onto that she’s not abandoning me, but I feel myself completely spiraling right now. She didn’t call me during her lunch like she said she would. And now I’m falling apart. Because, to me, this is an indicator of how the future is always going to be, that she gets too busy for me and forgets about me. Right now I just want to shut out the world and never go back to it. Life feels meaningless right now because I don’t think I’ll ever make it through medical school without her.

are there other possible explanations than the ones you offer? Maybe she got busy with something that was more urgent but no more important than calling you? That this is not in any rational way a referendum on her feelings about you. Can you recall the good feelings that she gave you which are YOURS to keep forever?

You are obviously very bright, but you do not own a crystal ball and you cannot see "how the future is always going to be."

What are some of the self-care tactics that you have at your disposal now?

I feel stupid now because I did overreact. She called me later and apologized because she was working through lunch on something else unexpected, and she called me as soon as she had time. She calmed me down a lot and told me that she will never forget about me and she’ll be there as long as I need her to be. I know she cares a lot about me, I just have a hard time feeling it sometimes. She said that she will show her emotion about this eventually, but that she needs to make sure I’m okay first before she can do that. I, in some ways love her like a child loves their mother. And she knows that on some level. And I know she doesn’t/can’t love me like that, but I know she does care about me like a mother does for her child. This is hard to deal with.

You over-reacted but that does not make you stupid. Like I said twice before, you seem really bright!

You are also stressed right now.

Can you give yourself a break, just a tiny one?

What are you doing for self care?

Right now, I wonder if you are struggling with a concept called OBJECT CONSTANCY.

I have struggled with it in the past and still do. It's probably because of genetics, background and a lot of other things. I could be way off base here but you may want to look into it; maybe it's not useful after all.

Basically, people who struggle with object constancy have a hard time holding onto the idea that others will give them consistency and continuity (and sometimes they won't, but anxious bids for reaffirmations of affection aren't always met with the desired response and can actually push people in the OTHER direction).

It has been a major lifetime developmental task for me to achieve some sense of calm about other people's feelings about me. But I am making progress.

You can too.