Originally Posted by littlethree

I have a quandry about "When is it time to end therapy?" for certain clients. There are many factors, however, and they seem complicated.

Factors include:

1. the medical insurance company is deciding therapy has gone on long enough (coming up on 2.5 years) and likely won't pay anymore.

- the therapist (a.k.a. "the guide") and patient (a.k.a. "the traveler") have discussed a few options about how therapy may continue, if and when the insurance decides to stop paying. but nothing has been formalized.

2. the patient has exhibited increased anxiety and fear and has become increasingly closed off in session.

- the patient is exhibiting "fear" and anxiety about:

(a). Being "jarred away" from therapy: being "jarred away" from a caregiver would create a trauma that would mirror and harshly reinforce past issues of mistrust and abandonment. Thus, the patient seems to be bracing for what feels like to this patient like a "foregone conclusion" that something -- even if not caused intentionally by the therapist -- something will come in to tear the client away.

(b) the client is also going into "deeper" areas in therapy and attempting to "draw" out more "fragile" aspects of self (visualized as a 2-year-old). Thus, because the client is approaching this "most fragile" part, the client seems to be pulling inward and changing direction to avoid putting this part in danger.

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Any comments or suggestions or resources to look to would be appreciated.