In my last post, I discussed how clients need to become emotionally dependent upon their therapists for psycho-dynamic treatment to be effective. How difficult the client finds it to tolerate his or her own needs obviously plays a major role in the development of that dependency. As I've said before, neediness is often one of the first issues we confront when we begin therapy: early experiences of untrustworthy or unreliable caregivers may have taught us that it's unsafe to become too dependent, making us reluctant to "commit" to the psychotherapy relationship. These are ongoing issues that repeatedly come to the surface during treatment, especially around the therapist's vacations, which often stir up abandonment issues or cause the old doubts as to the safety of the psychotherapy relationship to reemerge.

I recently returned to work from a 10-day vacation, and many of my clients had strong reactions to the break, none of them the same and each reflecting the person's particular defenses. During my early years as a therapist, I found that I often lost clients immediately before and after my vacations; nobody decided to quit this time (with the possible exception of the client I described in my last post, discussed in more detail below), but there has been more "instability" in my schedule than usual -- one session time "forgotten" by a client, some re-scheduling, emails expressing confusion about the appointment time, etc. This type of behavior usually (but not always) has a psychological meaning that you might uncover in the next session if you listen carefully.

Continue "Vacation Breaks in Psychotherapy and Defenses Against Need"