When Your Therapy Client Ghosts You By Vinodha Joly, LMFT on 3/2/20 - 9:57 AM

Ghost (verb) - Definition: to end a personal relationship with someone suddenly by stopping all communication with them.

What’s your first reaction to ghosting? Would it be to judge unfavorably the person who ghosts as disrespectful, unable to face and deal directly with conflicts, or, at the very least, impolite and ill-mannered? This judgement may very well be deserved. For example, in online dating or after an in-person date with someone they initially met online, a person may choose to ghost rather than deal with the discomfort of having to say they are not interested in continuing the relationship. The person “ghosted” is left without even comprehending (at least for a while) what has actually occurred. More questions than answers remain, and it is difficult for the “ghostee” to not take it personally.

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Might the notion of ghosting apply in therapy? As therapists, we must keep in mind and entertain all possible reasons when a client ghosts us and doesn’t return to therapy. Although it is not very common to have clients ghost their therapist, I have had clients who have let me know by email that they will not be continuing therapy--a milder, kinder version of ghosting, but a breakup nevertheless. To my chagrin, at times clients have refused to take up my offer of a termination session, even when offered without charge. As in all breakups, the one broken up with, (in this case, me, the therapist) is left asking the question: “Was it me or was it them?” I have often thought about and at times agonized over what I could have done to prevent this sudden rupture in the therapeutic relationship that now seemingly has no chance of repair.

Clients with abusive, traumatic histories place enormous trust in us as therapists when they venture to explore their painful pasts in our presence. Money is an often emotion-laden topic that is fraught with different associations and meanings to different clients. One client negotiated a low fee with me due to her many ongoing medical issues and treatments. During the course of therapy, I learned that this client was a millionaire who had inherited a great amount of wealth. We processed her experiences of scarcity and shame of having grown up in poverty. After many months of therapy, I brought up the issue of her current low fee and raised the fee by $20. Clearly, I had not processed adequately how that landed with her, as she ghosted me after that session and did not return to therapy. She also did not return my phone calls or emails, where I acknowledged my mistake and requested an opportunity to repair the pain caused to her. As a therapist, I take full accountability for what transpired between us, and I hope this client is able to process and work through her issues around money with someone else who holds her conflicts and predicaments with abundant compassion.

Only in one case of ghosting have I felt truly taken advantage of. This was when a relatively new client suddenly stopped therapy just after I tried charging their credit card on file for the four sessions attended that month, and the credit card was no longer valid. Did I learn anything from that? Probably not, as I still charge clients only at the end of each month using their credit card on file.

Here are some steps I now take to minimize the chance of ghosting, or should I say abrupt therapeutic termination:

  1. End of session feedback: At the end of each session, I take a few minutes to ask and go over with the client how the session was for them, especially whether there was something said (or unsaid) by me that needs clarification or that didn’t feel right to them. This gives them the opportunity to bring up the issue, so I can address it directly, rather than them not feeling understood, or worse, when a developmental trauma is reenacted in session and the client misperceives the interaction. In most cases, when a client abruptly decides to end sessions, it is usually related to an attachment trauma’s being reenacted in some way, where the pain is too much for the client to bring up in session.
  2. Need for closure: I tell the client at the initial session, and often throughout the course of therapy, the importance of a planned termination, or at least a single dedicated termination session. I also tell them that while it might seem easier to terminate abruptly rather than bring up a difficult issue directly with the therapist, a relationship grows stronger after an intentional repair by the therapist after a therapeutic rupture; I model this whenever possible.
  3. Offer a termination session at no charge: When a client lets me know that they are no longer going to continue sessions, I always offer a termination session at no charge. Even if the client does not take me up on the offer, it conveys to the client my interest and care for them, and that I am available and open to taking responsibility for repairing the rupture between us.

When a client decides to terminate abruptly and does not want a termination session, I let them know that they can always contact me in the future if they have any questions or would like to come in for a session. I also provide referrals to other therapists. In some cases, it is simply not the right time for the client, and I have had clients return to therapy, sometimes years after they had abruptly ended sessions.

I am learning to accept the “ghosting” of clients gracefully and to let go--it is what it is


File under: Musings and Reflections