Why people ghost their therapists

Three months after she began seeing a psychologist, Lisa started to dread the sessions. “I don’t know if I was getting better, but I was certainly feeling worse,” she said.

She began phoning to cancel, and then one day simply didn’t turn up. “After a few weeks, I was too embarrassed to get in touch. It was easier to walk away,” she said.

At some point in their career, many therapists encounter patients who, like Lisa, stop coming to appointments and end all communication. Or, to borrow a dating term, patients who “ghost” them.

It is hard to estimate how often this happens, but according to a 2021 report, 35% of mental health patients in England don’t finish their treatment, and a good portion of these are thought to leave without warning.¹

If we know that therapy works,² why are so many people walking away from their therapists without so much as a goodbye?

Avoidance

Oneg disappeared just two sessions after she began seeing her therapist. During the sessions, she felt like she’d opened up parts of her life and herself that she was “not ready to process.”

“I felt so much anger, like: ‘Why did you make me realise this? How could you?'” she says. Oneg knew her therapist was only doing her job, but therapy had turned out to be more challenging than she had anticipated.

Walking away without saying anything felt easier to Francesca than “taking responsibility” for wanting to stop therapy — plus, she didn’t know how to be honest about how she was feeling

Francesca had a similar experience. “I felt like an insect under a magnifying glass,” she says. “It felt voyeuristic on her part.”

Walking away without saying anything felt easier to Francesca than “taking responsibility” for wanting to stop therapy — plus, she didn’t know how to be honest about how she was feeling.

Clinical Psychologist Ryan Howes explains that patients often ghost their therapists for the same reason they sought therapy in the first place.

For instance, if a patient is going through a difficult grieving period, they may struggle to start another relationship that will eventually have to end, he explains. If they have difficulties handling conflict, they might prefer to ghost their therapist rather than “face a potential conflict when telling the therapist they’re done”.

Doing harm

Sometimes, though, the problem is not on the patient’s side but the therapist’s. “I didn’t feel safe talking to [my therapist],” explained Lisa. “Some of his attitudes were outdated and sexist. He denied an experience of sexual assault, telling me, ‘That is not how rape happens’.”

In such cases, walking away can be the healthiest thing to do — therapy is supposed to heal, not harm. Psychotherapist Tasha Bailey always recommends having at least one termination session before ending therapy, except if “you feel that the therapist is doing more harm than good.” “In that case, you should report them to their governing body,” she adds.

It’s important to remember that the patient-therapist relationship is a professional dynamic

You might feel that you owe your therapist an explanation or even have a sense of guilt that you’re “breaking up” with them, but it’s important to remember that the patient-therapist relationship is a professional dynamic.

A patient is also a client and “completely within their rights” to walk away if the exchange no longer benefits them, says Howes.

Getting closure

This doesn’t mean it is easy to be the therapist left behind. “Most of us get into psychology because we care about people,” said Howes. “It can be very worrying not to know what becomes of our patients.”

Generally, Howes will call someone a couple of times if they disappear, but “ethically, you can’t do more. You can’t chase them down,” he says.

Sometimes healing means finishing a series of sessions or writing a letter of gratitude. But sometimes, it means knowing when to walk away

“It is hard not to feel at least a little rejection, a little bit hurt,” says Bailey. The therapist doesn’t get a chance to review what did or didn’t work, she adds.

Patients who ghost their therapists also miss out on having closure and the chance to experience a positive goodbye, said Howes. “A lot of goodbyes in our life are negative: break-ups, deaths…for some people, the most productive part of therapy is experiencing a good ending.”

Francesca got a chance to experience a better goodbye with her next psychologist. A few years after their sessions ended, Francesca wrote her a thank-you letter, detailing the positive impact therapy had on her.

In dating, most of us can agree that ghosting is not the best thing to do, either for your closure or that of the other person. However, when it comes to therapy, the situation is not so straightforward. Sometimes healing means finishing a series of sessions or writing a letter of gratitude. But sometimes, it means knowing when to walk away.

Featured image is an illustration of a person’s hand holding up their phone, which shows three missed texts from their therapist attempting to confirm an appointment. The final two messages have been left on “read”

Page last updated March 2022