Whether it’s facing a long term fear, telling someone you love them, buying a house or deciding to stop seeing your therapist, how do we know we’re ready?

Sometimes things can be decided for us, a fear of needles may need to be faced if travelling abroad needs vaccinations. It may take a conscious balancing decision about whether the desire to travel outweighs the difficulties that will be encountered overcoming the fear. A fear of spiders may be tackled temporarily when you come across someone who has a greater fear and you’re the only one around to help remove said spider.

Other times there is a strong financial factor, buying a house initially requires a decision that buying a house is an investment that gives you what you want; it usually requires a deposit and a stable job in order to be offered a mortgage. So you spend time in months/years saving etc until you have enough and then you can deem yourself “ready”.

Most of the time, emotions will take a leading role. Getting married may seem logical after being in a stable, trusting and loyal relationship for a number of months/years but the idea of marriage commitment may well be influenced by previous relationships or experience of other people’s marriages. Are you surrounded by positive role models or by people who feel stuck in unhappy stale marriages? Have you been badly treated by a previous partner leading to apprehension? Including logical/rational decision making, getting married is the sort of thing you need to feel “right” about.

There are, however, other examples where challenging yourself before you feel “ready” is the best thing to do. For example agoraphobia does not disappear until you face the fear, you cannot wait until you are anxiety free to take that step outside. In fact, the hope the anxiety will go away while staying inside, it will only get worse.
Is anyone ever “ready” to have a baby? I know there are some people who were born wanting children and it feel natural but most of us, while wanting a child, will feel petrified and will have no idea how we will manage parenthood! If you wait until you feel ready, the biological clock would have run down!

So, how will I know when I’m ready to stop seeing my psychotherapist? My new job might play a role in this because the lack of shift rota in advance is making booking appointments difficult and asking for specific shifts has been frowned upon. I have been seeing my therapist for over 4 years and he’s seen me through a lot of challenges. I’ve known him longer than I’ve known my husband.

With my therapist I’ve broached the subject a number of times, talking about how and when to break off the relationship. The reason I’m struggling is that any other positive bond (friendship etc) would signal it’s a good idea to stay with it; but oddly, for this particular relationship, a good sign would be my ability to break it off and go it alone. At the start we were addressing specific issues in my history and current difficulties with my mental health. I’ve made great leaps of progress regarding my relationships with food and with myself generally. Now, he is someone I can easily talk to about everyday difficulties. My husband and I usually attend together and have found it useful to talk about our relationship. It’s also an important part of maintaining my mental health, staying at work and keeping a healthy marriage. I am very fortunately to have found myself in the position of appointments being available. I’ve been through other therapies that have been strictly time bound or situation bound (e.g. only in hospital). But I do not want to stay stuck, stay clinging onto “the system” unnecessarily. I want to be able to say I’m fully recovered. But whether I’m seeing my therapist or not, I still have some symptoms that may never go away.

How do you know when you’re ready to cut ties with the mental health system? Is the ultimate aim to cut ties? Wouldn’t this be a positive indication that you’re “better” or “cured”? But is mental illness something from which you can be cured? Don’t get me wrong, I whole-heartedly believe in recovery and believe I’m in recovery, functioning very well. But the experts talk about a “predisposition” or “susceptibility” – well if that has an impact on development of a mental illness, susceptibility would not disappear no matter how well you manage it. Anything could trigger a relapse and there’s always a stressor on the horizon (buying a house, having a baby or even how to manage going on holiday). I think support should be available at first sight of early warning signs to prevent another crisis.

Our mental health service is so stretched, the threshold for seeing a specialist (in the community mental health service (CMHT)) is set to severe or critical most of the time which means a lot of people have to struggle on under the care of a GP (who may not have psychiatric expertise). Believe me, I do not think everyone who has ever had an episode of mental illness needs to be labelled for the rest of their life or should hang around in the mental health system indefinitely. But I wonder if someone who’s had multiple severe episodes should still be expected to break ties. Someone with diabetes has yearly check-ups to test HbA1c levels and for any secondary effects (eyes, kidneys, peripheral nervous system etc) even if they are managing their condition very well. Shouldn’t this sort of support be available in the mental health system?

So, as someone who’s notorious for struggling with decisions, how can I decide when I’m ready to stop seeing my therapist?