How to Deal with a Therapist's Absence

My therapist will be taking a leave of absence for most of January due to major surgery. We spent the last session planning what to do since we won't be meeting for about a month. I have other people on my treatment team I can check in with, but not everyone is so fortunate. This made me realize it might be a good idea to write about how to deal with a therapist's absence.

Tips to Manage Your Therapist's Absence

1. Discuss Your Concerns With Your Therapist

Most therapists understand they have an important role in their clients' lives. They also understand that their absence, whether expected or unexpected, can trigger abandonment issues, especially in clients (like me) who have borderline personality disorder (BPD). They should be more than willing to discuss your concerns with you and form a plan as to how you will manage without them. They will be willing to discuss a mental health crisis plan, and what to do to avoid having to use said crisis plan. They will discuss coping skills to deal with their absence, whether it's a planned vacation or unexpected illness.

My crisis plan involves calling the local hospital's crisis hotline or going to the crisis intervention unit at the hospital if I am a danger to myself or others. If my symptoms are manageable but bothersome, I go to a crisis text line to talk about how to handle the situation--I recommend CrisisChat.org or 741741. I try to use coping skills such as drinking coffee, playing with my three pet rats, and playing video games. I try to distract myself and if I can't, I reach out for help.

2. Create a Support System in a Therapist's Absence

One of the advantages of being a member of Alcoholics Anonymous (A.A.) is the large number of people I can call if something goes wrong and I'm tempted to drink. Several members of my meeting have a dual diagnosis or know someone who has a dual diagnosis--that's a substance abuse disorder with a co-occurring mental illness. They're willing to talk to me when things go south. I have a support system of people who've been there.

My treatment team consists of my psychiatrist, my therapist, my case manager, and my care coordinator. Everyone has experience in working with people with severe mental illness. If one is unavailable, I have three more I can contact and they always have someone covering for them in case of emergency. I am not alone even if part of my treatment team is unavailable.

But say you don't have a fellowship or a treatment team. Build your own support system in case of a therapist's absence. Talk to a friend, a relative, or a religious leader. Join a support group, either in person or online. You can even try talking to a pet or writing about it in a journal. The important thing is that your negative emotions have a safe outlet. Having negative emotions at times is normal and does not make you a bad person, but it is important to express them safely.

3. Try a New Routine in a Therapist's Absence

If your routine has been disrupted because of a therapist's absence, try a new routine. For example, I have a part-time job that lets me set my own schedule, and I work two or three days a week. I also spend my spare time learning Spanish, Arabic, and Swahili. It is important for me not to get bored as that's when the self-injurious thoughts and intrusive memories come. So I have created a routine to keep me busy, and I've learned that when one part of that routine is disrupted, to rely on another part of the routine. For example, I've recently been reading about Mexican superstitions.

Make your routine something you enjoy. My love of learning other languages may not be for you. I'm allergic to jerk seasoning and won't cook with it, but you might find jerk seasoning to be a comfort food. What works for me may not work for you, and what works for you may not work for me. You know yourself best, so find what you enjoy and do it. Fake it until you make it, as we say in A.A.

How have you dealt with the absence of a therapist?

You can also find Becky Oberg on Google+, Facebook and Twitter and Linkedin.