This piece contains my personal opinions and some of the content may be triggering.
Sometimes in life we can’t control what is happening around us. People come and go in our lives whether we want them to or not. This can be hard to deal with. One big change can be when we lose a mental health professional who has been involved in our care for a long time. We may have come to rely on their help and support. We may have built up a good relationship with them. And then it ends.
As someone with Borderline Personality Disorder (BPD) endings can be particularly tough. Having a fear of abandonment means that when someone does actually leave our lives it is like a self fulfilling prophecy. Our worst fears are happening. This may lead to us getting involved in risky behaviours or rejecting the person before they are out of our lives in a way we believe will protect us.
Recently I was given the news that my care coordinator was moving on and I was going to have to say goodbye. It was difficult news to take as we had a good relationship and she was a great and supportive care coordinator. Getting the news made me feel like I was being abandoned as at the time there was no replacement on the horizon and no idea when one would be recruited. I was close to tears. Many thoughts went through my head including “was this my fault?”.
As I came to accept that this was going to happen I started to pull away from my care coordinator. This is what often happens with people who have a BPD diagnosis. It’s a way of protecting ourselves from a perceived abandonment even when it is not a true abandonment.
What helped though was the way my care coordinator rounded up our sessions together. She made sure my care plan was updated before everything ended so the next person would know what I needed help with and what I was working on already. Also in the end a new locum care coordinator was appointed so my old care coordinator could introduce me to the new one. This allowed her to inform the new person as to how often we met, what my major issues are and what needs to be brought up at my next psychiatrist appointment. It also helped to make a plan with the new care coordinator as to how our meetings would work.
What should a mental health professional remember to do when leaving a therapeutic relationship?
- Let the person know your leaving face to face
- Answer any questions about the change that the service user/patient has about the change
- If possible introduce your replacement to the service user/patient
- If unable to introduce your replacement, leave notes for your successor
- Tie up all loose ends
What can I do if I’m losing a mental health professional?
- Talk about any issues you feel need to be taken into account with a member of your mental health team
- Make sure you have numbers of people you can contact if you need help
- Create a support network (if possible) away from the mental health team
- Be open to a new mental health professional, remember just because they are new doesn’t mean they’ll be awful
Picture from Pinterest