When we’re working with a client’s fear of abandonment, it can add a unique challenge to the therapeutic relationship. You see, the client already has their rejection radar up. So we might become overly cautious to avoid doing anything that could feed into their fear.
Problem is, this approach can sometimes be counterintuitive. Not only that, it also might lead to one common therapeutic mistake.
In the video below, Christine Padesky, PhD will get into what that is (and how we might work around it).
She’ll also share some key findings that can help reshape how we work with a fear of abandonment.
Click here for full transcript
If you’re looking for more strategies for working with clients who have a pervasive fear of abandonment, check out this short course featuring Bessel van der Kolk, MD, Peter Levine, PhD, Pat Ogden, PhD, Stephen Porges, PhD, Richard Schwartz, PhD, and other top experts in the field.
Now we’d like to hear from you. How have you worked with a client who had a pervasive fear of abandonment? Please share your comment below.
I’ve always had a fear of abandonment & that was only emphasised more being abandoned. A councillor once broke down in tears & said to me ‘you’ve been let down by every single person in your life’. This was let down by adopted family & birth family, school & boyfriends. I never saw it that way. I am an optimist & look for the best in things & people. I only started to realise over the last decade how I was severely emotionally neglected & then narcissistically abused. I think abandonment issues can be far more complex . Even though I’ve always been an optimist & achieved the impossible I carried so much fear that wasn’t even conscious from ongoing abuse through life. I definitely have a fear of rejection as never felt fully accepted or embraced. I am fine with my own company though & Autistic traits so I can appear like I’ve no issues.
I realised I suffer from PTSD to the point it made me chronically ill. It’s interesting how things can get complex quickly. One thing for sure though is I’ve been gifted with a huge amount of empathy & understanding from all of my experiences. It’s simply not enough to say it’s a job – therapy.. For sure it’s an inside job & anyone else can only help facilitate.
One thing I’ve found useful is Internal family parts, yoga, mindfulness, creating music, studying art, photography, writing, and much other work involving belief systems.
I feel the more I’ve found myself & who I am , the more I’ve understood where I’ve been & how far I’ve come I am feeling more content with who I am completely by myself with myself. I’ve been isolated for a long time.
The scariest thing has been reaching out after years of abuse because of the conditioning & trauma. Gradually through finding some support I hope life will change this year. Therapists have a huge heavy weight at times I am sure it feels like to help fix things.
I quite believe in progress independently . I know this is hard if you have ever been codependent. I think the key is absolute love & kindness towards yourself & the relationship you build with yourself- the voice in your head- that relationship with yourself even down to the tone. This is why influences are so crucial… get surrounded by inspirational people, listen to them .
You become like the 5 most often people you surround yourself with. And make a note of that smile on your face how great it looks on you & what eases any stress & worries. – you deserve great things. There’s a certainty in making any choices … make sure you make the one you are always growing, moving forward in some way even if it’s learning how to slow down & take a deep breath or 3, looking up to notice small things in life & leading with your heart. You, will like I now I have and am starting to will find the answers with time . Just keep going – but most importantly know you are enough, this is my message to anybody listening, clients or therapists X
Thank you so much for this comment. I can identify with so much. You have confirmed some things I’ve been thinking and reinforced other things. You have so much wisdom and I also have the deep empathy and understanding. Old souls! I’ve been over-focused on looking for a therapist but the relationship to me myself is #1!!! I like how you write “I quite believe in independent work”. It seems to me lots of therapists will control and understand that’s because they want to help so much. They say it’s client-centered but then “nudge” you. I personally think CBT is insulting. Very seldom have I not thought of a new perspective they want to give me. I’m a deep thinker. I’ve found my cbt app better, she only gives me work on distortions when I’m ready. And it’s free 🆓
This is great information and reaffirm the approach that my therapist is taking with me. She doesn’t reassure me, and instead gets me to think about things myself and self-sooth as opposed to looking to her for that.
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I am an 81 year old female who has done a great deal of work on my own and have had therapy back in the 90s. My sense is that there are few healers who have grasped the depth of wounding that I feel is cellular.I
“Marinated” in the womb of a woman in 1940 who was told by her new boss that if he did not get to “pleasure” himself(rape) at will she and her brother would be fired.She got pregnant , carried me to term and gave birth to me ,sight unseen.I feel I developed in that womb absorbing much of her rage,helplessness etc..I have not found any professionals that understand the depth of the core wounding/trauma that we/I carry in my body.I had a healthy enough family for my development in the 40s-60s;;however,that came with its own baggage just because of the times and closed records/secrecy until 1995 when TN opened their records partially due to actions I took with the legislators.Can anyone tell me that there he’s been a great deal of progress since then? I am known as Dreaming Bear and I have lived on 70 acres in the NGA mtns for 46 years.Thank you for asking for a comment as that feels like and invitation to a start , or maybe a finish.Personally,I feel that I have done so much work that I can support others . Again, that is part of a repercussion ,taking care of an infinite amount of problems in others at a rate bordering on A D D.
Really good. Feedback from both sides. And beneficial. For dealing with this very unsettling fear.
Absolutely. I’m so sorry you had this experience. Sadly you are not alone in this as I am seeing more and more in the groups I am a part of that therapy can be a complete minefield for people with attachment disorder and early life trauma. Unfortunately it is not an industry that adheres to high ethical standards of practice and therapists ultimately get away with treating clients appallingly in many cases. I’m sending you care and empathy. (The other response you received really well sums up exactly the kind of disregard and lack of morals that many therapists have frankly.)
I think this is quite misleading and not a one size fits all approach as is conveyed. Abandonment wounds require the utmost care and gentleness to avoid retraumatisation. You only have to look at the countless painful testimonies across online groups from people who have been made to re-experience their early traumas again in therapy to know that we need many more highly skilled, properly attuned and trauma-informed therapists in the profession. Also, I wouldn’t suggest CBT to anyone with CPTSD/BPD or indeed to anyone at all – superficial and often short-term behavioural changes are not the answer to complex trauma. How could they possibly be when there’s nervous system dysregulation present, when there’s deep shame, a complex inner world of conflicted parts etc etc? Behaviours are the symptoms, not the cause.
Is there a way to read the study that is being referred too? I’d be curious about what exactly was measured, and also if there have been follow-up interviews esp. about the kind of relationships the participants have had later on etc.
I’ve observed that often in cognitive based therapies – and i don’t want to doubt their helpfulness in the right place and time with many clients – lots of success around overcoming fears actually results from the client shifting into a dissociation rather than a resolution of the fear.
Sometimes the think goes around! Many therapist broke therapy (intentionally or not) for their own reasons! Overwhelmed, tired, exhausted by their patient’s “needy” behavior’s prompt by strict core beliefs such as ” I don’t deserve to be loved”, “I must be left alone”… Community work with complex child trauma (cPTSD) requires a degree of commitment (and some role complexities) far beyond the “mainsteam” therapy practise in any given psychotherapist office.
I encourage clients to take a session fee and use the money to do something lifegiving and fun instead of therapy to invite them see a reward of not going to therapy. I also spend time having them dream about their future and encourage them to create dreams and desires for their future so they can begin to see a life and future which helps them begin imagining a life without trauma.
Women (mud age) and youth need to experiment and develop practical strategies and be given the means to do the activities that help them.
Eg its costs a lot to do outdoor Adventure activities or a 12 week program with obstacle courses and challenges with therapeutic considerations. This would really help a “ start and end date “ to a development 12 week basic training course.
Giving people confidence and felling less helpless. Talking weekly is emotionally draining and the sitting still is painful. It’s not a healthy attachment to a therapist and I have found the same gut reaction talking to therapist as the tormentor in a controlling relationship.
Termination with a client is an expected part of therapy. It’s not supposed to last forever. It can/should be both safe AND ethical when done correctly. Sometimes we HAVE to part ways with a client. Sometimes we move, sometimes we start a new job, and sometimes we’re not the right fit for the client. We should always offer referrals, though, for finding another therapist to replace.
Really helpful findings and information. Thank you.
really interesting what Christene said that we need to develop clients confidence and independence rather than promising them that u will not abandone them. thank you.
A very helpful insight. Thanks!
I have experienced what you described about the fear of abandonment and its need to be dealt with carefully. Abandonment can feel cruel. I think that being gently aware of this from the start of therapy is important. Near the beginning of therapy, communicating ways to cope with time apart, can create a consistent learning process that slowly readies a client to handle absences and even the ending of therapy. One suggestion is to ask at the end of some sessions, how will you take care of yourself during this week, or before we meet again. Beginning this readiness process at the beginning is a caring for the client.
When we realize we can manage independently, growth occurs. It would be interesting to know the specific changes which occurred post therapy. When working with youth, the greatest change that I observed was when termination was by their choice. I interpreted it as a sense of readiness.
Thanks for sharing.
I have had that fear of abandonment and use small steps with myself to move forward. I do the same with clients and it works well. First I reassured them that I am there for them. Second I work on building tools that helps them when they feel scared. Third I get them to use these tools and slowly move out on their own. This could take months but sometimes weeks depending on how ready they are. Thank you for sharing.
I really appreciated what Christine had to say. I was one of those clients that had experienced extreme abdondoment, by a parent at the age of two due to medical reasons and at eight due to a death of caregiver.( When I was ready to finally address this issue. I had two individuals (male and female) that walked with me, but I did transfer my need for acceptance, my little girl needs were impacting letting go and becoming the individual I was met to be. It did take having both of them stepping back for various reasons before I could fly. Today as I council teens I am much more aware how quickly in some cases that can happen. Initially very frightening to let go, but can now I see it as a major step of my healing and allowed the reconnecting of broken relationships as well as fostering the courage to invest in new ones. Abandonment can certainly leave an individual with many years of -a cloud you can not explain to others. I am so thankful that feeling is gone and replaced with energy and joy of each day.
I agree. It’s been tough finding a therapist who knows what they’re doing. I’ve asked most therapists the same question: why did you become a therapist. They ALL give the same answer: because I want to help people. Too bad people often don’t tell the truth. Most types that lean towards becoming a therapist are those with their own big problems that they’re trying to figure out / heal, and those who like being in a position of power, and having a career.
In my journey I’ve seen probably about 20 therapists. 4 of them for a year or more. I’ve never met one that could empathize with me, attune with me. In my opinion it is attunement, mirroring that is cathartic. It takes a mature, centered person who has already worked trough their own stuff to be able to do that. Talking about someone to an emotionally unavailable person is like talking to a wall. Good thing is walls don’t charge $150 for 50 minutes. Well, sorry, looks like we’re out of time. See you next week.
Spot on. My therapist terminated me at beginning of 8th session. I was never prepared for it. As the coward she is, she wouldn’t even tell me face to face but by phone. No empathy.
I got into outdoor adventure therapy and secondary teaching youth development because I had a good early life and recognised from an early age because of my family opportunities and a school very much focussed on a great outdoor education program with the motto “we learn and grow” . So schooling and scouting and other outdoor activities demonstrated to me how great it was for my teenage years and mental health and I wanted to give kids the opportunities they wouldn’t necessarily get that I was fortunate to get.
Hi, thank you for the video. I am a therapist but I go through a separation. For months, I have been back to my psychologist for treatment and recovered from depression. I have seen the progress in my attachment work with him becasue he has become a secure base that helps me to stay centered. Oh gosh, I have been in foster homes at early age and this decision to take off and be on my own, ‘d made it possible for me to gain some on control of my life. That was part of the goal. I don’t see myself as an insecure person as I was, I know, that I have a place and a home where to come back to. Centered.
As a psychotherapist specializing in complex developmental trauma in higher functioning adults, I find that it generally takes a long time for clients to build a secure attachment relationship and internalize my myriad ways of limited reparenting functions.
As they do this they often move from avoidant attachment styles to vulnerable feelings of dependency and then to a deep secure attachment relationship. like
Like children growing up in a loving secure attuned environment, they naturally become more and more individuated and confident and independent.
As an trauma therapist, I see that the slow growth of a secure attachment relationship frees the clients to become authentic, strong, emotionally capable of separating in a healthy manner.
The fear of dependency in a patriarchal society is sadly epidemic.
Thank you for this comment, Nicole.
It’s unfortunate that despite all the scientific knowledge about the nervous system and development, psychotherapists with your mindset, attitude and “open” observational skills are still rather rare. It’s very much appreciated you speak up.
I am a Cognitive Analytic Therapist. We draw reciprocal roles and name abandonments as a place of fear or avoidance. Part of the therapy is a reformulation letter which is a summary of their story, in the letter in it we point out the procedures that they learnt in early life . So if abandonment is one their reciprocal roles we say at the end of the letter what difficulties may show up between us for example “ You may feel abandoned by me as therapy comes to an end of you may abandon me first .I will be encouraging you talk about any difficult feeling which may come up for you.” Especially if that’s a pattern that they have of abandoning others before others reject or abandon them.
If I’m ill or on holiday I will talk to them about whether they felt abandoned. Sometimes clients won’t turn up to the session after a break. CAT uses transference in the therapy.
It seems affective.
I would be keen to know about attachment disorder in teens who have experienced trauma and abandonment.
Thank you
The answer to abandonment is to reprogram the brain for a positive, rather than a negative expectancy. Trust takes time. When working with a person who has abandonment issues you must literally set up opportunities to build trust.
Eg. “I will be there at 6:00 p.m. to pick you up.” (I arrive a few minutes
early)
The way to reinforce a positive expectancy is to communicate clearly and then perform appropriately.
Thank you so much for your post. It makes so much sense but I’ve never met anyone who understood how important it is. It was such an enormous relief to hear someone describe exactly what I need from other human beings.
Unfortunately, in my case I still haven’t managed to find people who fulfill even their professional responsibilities, not to mind provide the level of care you’ve described here.
It’s good to know that there are people in the world like you.
Thanks again for your post.
When you’re talking about reinforcing a positive expectancy, you’re talking about a external expectancy, something outside of one’s control. It is difficult to create that type of an environment and is impossible to control for even in a therapeutic relationship, as in your example, if there is traffic or an accident there are no guarantees. What I think is more relevant is developing internal resources and self-efficacy that does not rely on positive expectancy from external sources but can find those Positives from within.
Shift the thought to release the tension and stiffness of the body. Usually will switch the intense feeling. Holding the though and positive talk. Even when one think there is nothing wrong with them!! Highly egotistic ?
???
We walk a fine line, do we not? Between having the client lean on us for a time and then lean on/live in their own strength and understanding as they get healthier. I have grown to see it as a walk from dependency, to a sort of inter-dependency (can’t think of a better term) and then to independence. This mostly comes as a walk, not a sprint, and hopefully not a marathon. Often the separation, though painful at the time, is the catalyst for real individual growth.
Hi, Dorothy – by any mean, it can be a hurdle as what to stay on course – separation anxiety can occurs from early age and with some indulgence for a lifetime, if we don’t learn how to live independently because then it could mean becoming a “burden” for the persons we love. I have seen this in others and in my teen;s So, it is a matter how we present it and have the acceptance about what would be the outcome – as being present
Thank-you for your post. I think we have to continually work on an individual’s strengths which you reminded me of in the talk.
I like the comment below about how we can suffer from projections, interpretations, judgments etc. and then we lose the purpose in mind to conform to the standards…this is something that we need to face when working in this field. For me, when triggered I can lose my calm and chose to flee to protect myself and I can’t have any room for another person’s anger. My instinct is to give up trying and let it be me. This is to say that it all comes down to how triggers are dealt with on a personal focus. Thank you for all the comments
I live this training video in particular because it shows a realistic time and situation with a real problem . The result is quite hopeful as well. Well done, thanks.
Promises, promises …….. I wonder
Does a promise imply taking responsibility for another?
A therapist can’t take responsibility for a client’s pain. Nor, because of circumstances, exacerbate pain by being unable to continue with that client.
(What Dale, below, experienced is totally unprofessional and unacceptable)
Therapy, I believe, is “educational” – how to enable someone to manage themselves, rather than try to make the past go away.
It’s not easy to ask someone to unfix themselves rather than be fixed!
And perhaps we all need to consider that maxim “physician, heal thyself” – a tough call …… but it might allow us to do what Robin says below and adapt.
Thanks Christine, Ruth, et al
I have been a therapist for many years. And, I have learned to not please my clients under any condition because I can’t own what they are going through. I am here for them so that there is no abandonment from my part. Some clients would seek extra support from outside of the therapy and show fear of being judged because of their culture. I only respect their choice but I know this can have a great affect on their life. There is nothing to fix here, especially when it doesn’t need to be fixed. Sometimes I never see my clients coming back, if only, in the hallway, to another office.
Thank you, Christine, for the specific and personal example.
So much work seems to need the scenic route to follow and even our ‘mistakes’ can help.
In my work, describe the ‘small defeat’ – learning and adapting even when things go awry. The aim is to identify in what way client and therapist can grow from small defeats.
Christine may well have seen that incident as a large defeat, and it is good to hear the client could still make it work for her.
Robin Trewartha.
Thank you for the enriching video. I think abandonment during and after therapist can cause a sense of being betrayed, hurt, guilt and blame. Not to say injustice and ANger that STEaM from hurt? it can make all the work becoming useless or reversed to from where the therpy started and endlessly .
In response to some comments below, the topic and the video. What I have found both personally and professionally, therapists should be invested in really hearing and observing what that client is saying. Sometimes as Christine pointed out the client is to be empowered for their own growth. The therapist is there to help with the puzzle, to find the connection to put the pieces together with the client in their head, their heart and this wonderful nervous system finally on line to help this resolution for the first time in a life’s long struggle. Struggles with early attachments, parents who were not taught how to parent or even how give birth. Parenting classes I have found the most affective not just on how they are parenting their children but to see how they were parented ineffectively. This is hard and long work, not the quick fix that many think. They need to warned it is a process, not to expect a one step tool. Breathing is great but it is not the total answer, nor is yoga or exercise. although those do help. I think people need to stop focusing on single commercialized fixes, get back to meeting the client where they are, hope it is a match but also aware of the client needs at the time they walk in the office with all their preconceived notions. An open and problem solving minds is what is needed here. We know there is all sorts of false information corrupting the media, television shows and commercials pushing drugs and health issues incessantly without the total truth regarding the long thwarted nervous system, presidents asserting that the mass shootings are due mental health instead of monitoring gun control reasonably… People are willing to go to a doctor for their stomach, take the drugs given but never think to go to a mental health professional to coordinate thinking styles to assist in healing the body or even the cause of the stomach ailments when understaning the Doral Vagus nerve or any other problems that their nervous system is crying out for understanding. Our long standing lack of the answers within our own body play havoc in faulty relationships. We need to realize that the nervous system should be on line to help us see their body as a wholistic connection. A connection long thwarted by parents who were not taught how to parent, teachers to understand how a child learns, starting with the nervous system being fully engaged to learn or doctors who just prescribe meds for infection instead finding the cause or the ramifications that some infections cause within the body for later failure within the nervous system
A therapy or therapist is effective and a match or it is not. I believe it to be the responsibility of the therapist to check that after 6 months and every other six months after that. I was once in therapy for 4 years and for a very long time noticed i was getting worse. When people like me go into therapy we give up part of taking care of ourselves and trust that part to the therapist. Giving up our personal power. I kept waiting for the therapist to catch up with my knowledge, but she never did. The very first time she gave me a warm and heartfelt welcome. Something i was not accustomed to and cherished. We were going to apply a kind of Kahuna (Hawaii tradition) massage that brought me deep within. It worked that first session, which lasted for hours. Then she fell down the stairs, tore something and could not give a second session. I then entered into talktherapy. Waiting and hoping for her to recover and give me the massage i felt worked for me. In retrospect she should have found a colleague giving the same kind of massage. I became the proverbial Broken Record, deepening the groove in my brainwiring, whilst also in retrospect damage was most likely already permanent with in retrospect CPTSD/DID/Attachment Disorder and total Insomnia/Chronic Stress. I found the courage to end the therapy and had to deal with a crying therapist. Possibly it made me stronger to really feel whether a therapist or therapy had something to offer me. To end therapies i observed were not good for me. With the Dutch Healthinsurances and living on a very low budget it means there are limitations on the therapists i can consult. Most new therapies are done by practitioners not working for Healthinsurances and due to their costs thus unavailable to me. I continued studying the matter and bought some systems to be my own therapists. In the end i gave up the hope of full healing but am managing with supplements, some methods, books, vids and your online seminars to stay stable. As for abandonment i object to the word fear. We are often hypersensitive, extreme empaths. We feel what others do not feel in the energyfield of others. And sad to observe most people leak energy, suffer from projections, interpretations, judgements etc. I call it people without noise, without a hidden agenda, those i can be me with and own my right of existence, denied to me from the moment of conception. They are rare and precious. Sad to observe, but people with mental health issues are often discriminated against and thrown away like garbage. Not fear of abandonment always but most people all too ready to abandon another human being. Finding them to be a burden, too negative, ashamed to walk next to them in the case of f.e. alcoholism, too depressed etc. etc. Being abandoned does not make me fear abandonment for i am very skilled to handle that. To walk the path with a new person or my adult children, to discern on whether i can expect abandonment, untrustworthyness, adultery and/or neglect and how to decide then on whether to continue or end the contact fall into the skills of attachment and in those i was never socialized/skilled and i suck at those.
I somehow feel that we can (and need) to make the commitment (which is a promise) that we will not turn away from clients before they are ready to go, however, we need to clarify that life/soul (a hand mightier than ours) is in charge and if/when life calls for it, because of changing personal circumstances, the time is likely right and what follows will/can be growing pain.
Such a lovely, gentle way of seeing the end of something. I will hold onto this!
I absolutely agree with this approach. So many times i talk to individuals who have been going to therapist without any visible progress. They are so attached to the therapy hour that just thinking of it being discontinued triggers a panic attack. The dependency/attachment is not healthy and not helpful
It’s been 7 years, four months, and four days since a therapist abandoned me mid-session out of apparent frustration, anger, and boredom. No preparation. No warning. Just “we’re done.” She later blamed me for the trauma and distress – which I deeply feel to this day, saying I just “took it personally.” If you have to – or just want to – terminate, it matters how you do it.
I am sorry Dale, it goes without saying that as a therapist, because therapy is very “personal,” she failed you, however, as a mirror of how collective forces might react to patterns you present she was letting you see that she could not be with and stay with her own personal reactions without shutting down and cutting you off. I feel what got exposed is her inability to be with and stay with her own personal reactions and to take responsibility (instead of enacting) them. Hard to accept because yes, in the role of therapist “it matters how” we terminate.
I am so sorry you had such a callous and insensitive therapist. I hope you know that it was her limitations and not yours that caused this painful rupture of trust. You are not to blame. Thank you for sharing your experience. I know it will help other therapists to know what it feels like on the receiving end.
Dear Dale, I hope you haven’t given up your therapy journey. It sounds like she was ill qualified. She may have completed trainings but in this field, its attending to our own personal trauma that determines our ability to really attune to our clients. Keep stepping forward Dale!
In my late 20’s I went into therapy. Extreme child abuse. Cptsd,DID,MDD & severe anxiety. To make a long story short I was “taken advantage of” (went to bed with) two male therapists. Got him fired. Been hospitalized for depression a couple of times. I am a fighter & now in my 60’s have returned to therapy (had to), got a correct diagnosis & getting real help for the first time. There are bad therapists and good ones. Follow your gut.