Is it Time to Leave Therapy?

Why I Started Therapy and When I Knew it Was Time to Leave.

This is a story of the benefits of therapy, how I used it to change my life and heal, and when I knew it was no longer a necessary tool in my life. This is not intended as medical advice, rather food for thought from a professional patient, not a medical professional.

Why I Went to Therapy

I needed to be heard, to have a safe place to vent, to simply have someone listen to me, and reflect back to me what they were hearing, so that I could hear it too and in doing so, create change. It had to be a therapist and not a loved one, so that I could avoid putting friends and family through compassion fatigue and burnout. Therapy provided an impartial, yet professional, perspective.

I’d had short-term therapy, off and on, throughout my life, to help me processes various traumas (domestic violence, sexual abuse, and other adverse, childhood experiences); but it was never something I was able to fully commit to, because of finances.

When I couldn’t afford therapy, I went to twelve-step groups, usually Al-Anon (created to support family members of addicts), which were donation based and incredibly helpful. In twelve-step programs I heard other people’s stories, discovered that I was not alone, created community support, and learned various therapy speak terminology like: active listening, accountability, and boundaries that helped me build better communication skills.

After my Vascular Ehlers-Danlos diagnosis, and years of jumping through hoops in a landfill of red tape bureaucracy, I finally received disability. This paid for the consistent therapy I needed in order to heal, not from anxiety and depression, but from grief and fear of leaving my daughter a motherless child due to a newly diagnosed shortened life-expectancy.

Diagnosis is Mostly for Insurance Companies

Therapists use medical codes for diagnostic purposes to get insurance companies to pay for their services. To the best of my knowledge, “grief & fear” are not amongst any commonly used medical diagnostic codes. The closest they can find are “depression & anxiety.” It matters what we call it because grief and fear are transitory states we can overcome, whereas depression and anxiety have become identity labels. We cannot heal if we feel we are the disease; but we can heal, if we realize that it’s not who we are but rather something we are experiencing, and experiences can change.

You are Not Your Diagnosis

The first guidance I would offer anyone who has been diagnosed with anxiety or depression would be to see those as blanket terms used primarily for insurance purposes (medical coding). These terms cover the foundation of the true feelings creating the conditions. When we pull back the cover of “anxiety and depression,” we can discover what lay beneath, which for most of us is another generalized term: “stress.” If we dig deeper, we may find, as I did, that the primary stress I experienced was loss being expressed as grief and fear. The more specific we can get, the easier it will be to heal, repair, and move on with our lives.

The Dangers of Pathology

To read and understand more about how diagnosis can be used against women, please read the brilliant work of Dr. Jessica Taylor, who argues that women and girls are being deliberately framed as mentally ill when they had been abused - specifically, that they had been told they had brain chemical imbalances and mental disorders.

The Myth of Chemical Imbalance

There is a prevalent social belief (propagated by pharmaceutical companies who profit from this belief) that anxiety and depression are the result of a chemical imbalance in the brain. The truth is that there are no definitive tests for chemicals in the brain (despite urine and MRI scans that claim to be so). To support this point, there are many articles, like this one from the National Institute of Health entitled, There Is No Such Thing as a Psychiatric Disorder/Disease/Chemical Imbalance or this one, How Should We Think and Talk About Mental Health? From The University of Michigan, or this one from Science Direct, Is the Chemical Imbalance an ‘Urban Legend’? An Exploration of the Status of the Serotonin Theory of Depression in the Scientific Literature.

Yet, there are people who hold to this belief because they notice a great difference in their behavior when on medication, versus when not. Medications medicate; that’s their job. It’s not unusual to feel more sedate after taking a sedative. That doesn’t mean there’s a chemical imbalance in a part of the brain that makes sedation effective; it means the medication is effectively medicating.

Believing anxiety and depression are solely due to a “chemical imbalance” can create false identities and be a gross negligence to actual healing. According to the doctors I’ve spoken to over the years (my own neurologists from Stanford, Mayo Clinic, and Cedars Sinai), testing for chemicals in the brain would require brain surgery; and even then, there are no effective tools for accurately measuring these chemicals because they are ever-changing.

Additionally, neuroplasticity has proven that with new experiences, the brain can heal. Therefore, if we are told (and then believe) that our problem is a chemical imbalance and the only cure is medication, then we are disempowered to change our behavior and neuroplasticity of our brains; and we can become dependent on medications, which wax and wane in effectiveness. Alternatively, if we change our behavior (and our brains), we could potentially be in control of our healing and change our lives.

The cause of anxiety and depression is unknown but believed by most scientists to be a combination of genetics, environmental triggers, and life experiences. Accordingly, knowing that environmental triggers and life experiences can be transitory and understanding that neuroplasticity may alter genetics through cognitive behavioral therapy, we come to see that our diagnosis of anxiety or depression may be more mutable than once believed.

The Benefits of Medication

For those who experience episodes of psychosis leading to thoughts of harming themselves or others, medication can literally be the difference between life and death; and I wholeheartedly support and encourage it. However, that doesn’t necessarily mean the person experiencing psychosis has a chemical imbalance in their brain.

If sanity is homeostasis, medications can be useful tools to rebuild one’s home; but they are not the home itself. My intention with sharing this is to inspire and empower others to know that healing is possible and conventional treatments don’t have to last forever. This is my story of healing and knowing, when I no longer needed therapy or medication for “depression or anxiety.”

I took a non-SSRI antidepressant for about five years, as my body transitioned from post-partum hormones into menopausal hormones. (I was an older mom, so this was a shorter road for me.) It’s a common practice in medicine to treat women with hot flashes by offering an anti-depressant. When I asked about how the anti-depressant controlled body temperature or stopped hot flashes, I was told, “It doesn’t change your hot flashes, it just makes you care less about having them.” Medical research on the female body seems to be an afterthought at best and negligence at most.

Hormones absolutely can impact our mental state. There are many ways we can balance them out from drugs to lifestyle habits. I tried everything that was recommended that I could afford. It took me about five years to integrate healthier behaviors and gradually ween off my prescription drug. Then, it took me another five years of trial and error with my new lifestyle habits before I could learn how to sit with discomfort, without reaching out to a therapist while I waited for it to pass.

Personally, I found the process of finding the right medication and navigating various side effects, with the combination of slowly weening off the medication when it was no longer needed, to be so disruptive to my body and life that I would not choose medication again, unless it were deemed necessary for my survival. Having said that, when I chose to take it, I absolutely felt it was necessary, I’m grateful I had it, and I believe it was helpful.

Once again, this is not to negate the necessity or value of medications, which can be absolutely essential and lifesaving for the most severe cases and help those with more mild cases of anxiety and depression feel better and as a result have a more manageable life. What I am sharing is not medical advice or any suggestion to start or stop a medication. These are decisions between you and your health care provider.

Depression

I was not depressed; I was grieving, and there is a difference. Depression is despondency and dejection (which is a type of sadness). I only experienced true depression lasting 6 to 12 months, a few times in my life after tragic deaths of loved ones. Grief, by contrast, is sorrow caused by loss. By asking myself what was causing my sorrow, I discovered that it was multiple layers of loss.

Therapy became five years of sitting shiva with my past and another five years of learning how to function, through integration versus escapism. Therapy, in the end, was about learning to be present with pain until it passed. Bit by bit, day by day, year by year, I processed my hurt, and developed new habits, skills, and commitments to parent myself with love and compassion. As the grief “depression” and fear “anxiety” lessened, my energy and ability to face challenges were strengthened.

It was not unlike the proverbial frog who falls in the cream and in the process of swimming so as not to drown, churns butter, creates “solid” ground, and is able to free itself from the place it had fallen into.*

I was praying but moving my feet. I did the brave work of introspection, looking at the unpleasant and uncomfortable truths that most people prefer to deny or ignore, and taking ownership for my reactions and every part I played in co-creating my experiences. In the process, I changed my life. I healed past hurts. I became the version of me that I always knew existed but was buried under too much grief and fear to fully be, before this excavation work.

Grief

Julian B. Kiganda shares in this episode of The Soul Therapy Podcast about how grief comes in waves. Years ago, I compared it to a road that needs to be repaved from time to time as triggers can create new potholes requiring us to revisit of grief.

My grief was from loss. I’d lost many family members to death and others from neglect and abandonment. I’d lost my health from a medical diagnosis; and as a result, I’d lost my dreams. I’d lost myself due to dysfunctional relationships I held on to, as a way of making up for what I’d lost in childhood. I’d lost my identity, community, and remaining family, due to a situation that forced me to change my name, move, and start over, without knowing a single soul; and the new relationships I forged were hindered by not being able to share the full truth of who I was.

My body and mind had become an overwatered garden of loss. No amount of sun could penetrate the seeds I planted (I’m about to beat the Hell out of this metaphor, so please stay with me). I watered the garden of my life by drowning it in so many tears that it created mud and was unable to grow anything other than uneven ground and sinkholes of despair (I have to find ways to amuse myself in order to endure my physical pain- feel free to laugh with me). My grief was blocking the sun, and it was my own shadow; so wherever I went, it followed (now, that’s a fact!). The only way out was through. I had to muster the courage to face the pain, accountability, and mourning required to heal and stay above ground (dramatic, but all true).

Grief is all about loss; and until I could come to terms with letting go of what was gone, I was unable to move on without the ghost of regret weighing me down. The only tool I ever found to help with regret is forgiveness, which I write about here: He Broke My Trust and here: Sage Words FREEDOM Book One.

Fear

When I was a child, I was diagnosed with PTSD (post-traumatic stress disorder), not cPTSD, but straight up PTSD. Definitions are always changing and as a result, so too perceptions and treatments. At this point in time, I would be more surprised to find someone who did not have PTSD after the pandemic than to discover someone who did. Anxiety is fear. Plain and simple. It’s a normal response to stress.

The main difference between someone who is anxious and someone who is not is the degree of awareness they have of the stress in their lives and the resources to manage it. The more money a person has, for example, the less stress they feel about finances. In fact, one of my therapists said that 90% of her clients were in therapy due to the stress around financial insecurity; as their financial situation improved, so too their mental health.

The phrase “ignorance is bliss” can be applied to someone who seems unbothered and unanxious by stress. The people who like to brag that they don’t suffer from anxiety tend to be people who indulge in escapism (an excess of time spent with TV, books, video games, drinking, drugs, gambling, sex, overeating, exercise, etc.) or people that either have training and a practice in spiritual enlightenment like meditation, or a faith in a higher power, or a belief in fate and determinism that relieves them of any social or personal responsibility to change.

Precognition

The reason I was diagnosed with PTSD at such a young age is because I have an added factor that contributes to my anxiety, and that is precognitive abilities. When you can sense something bad happening before it does (like the Northridge earthquake, Columbine, 9/11, Thailand tsunami, and more), it deepens and doubles anxiety. In addition to that, I have an autonomic medical condition that causes physiological anxiety, which is different from psychological anxiety. Together, these three elements can make for a powerful punch to the gut, especially when unchecked. As someone with the Curse of Cassandra, I don’t have the luxury of escapism or denial from my anxiety: that would be like being able to ignore a screaming, crying child in anguish who was an inch from your face—something I am not capable of doing. I had to find a way to integrate my anxiety and live my life without it paralyzing me.

I define anxiety as a specific type of stress: fear. Once my insurance began to cover therapy, I was able to identify my fears, which were in essence a fear of more loss: fear of dying and leaving my daughter without a mother, fear of lack of income leading to being homeless, fear of what was happening in the world environmentally, politically, and socially. The theme that occurred over and over again was a fear of more loss, of not being safe, of being homeless.

Therapy isn’t just about the mental process of pain, but the practical actions we can take to ease that pain. For example, one of my great fears was my daughter having to choose between living with people she didn’t feel comfortable with or being homeless. Since I couldn’t afford to buy her a house, I bought her a hard-shelled camper (it’s like a tiny home on wheels that she happens to love), so that she would always have a place to live that was her own. Taking that action, in and of itself, alleviated a massive amount of anxiety. In therapy, and through spiritual practices and the study of philosophy, I was able to learn how to better manage fear, loss, and grief—all of the things that lay beneath the topsoil of anxiety and depression. Eventually, through the following six signs, I was able to recognize it was time to leave therapy.

When We No Longer Need Therapy

Some people incorporate weekly therapy into their lives, as part of mental health maintenance, and never plan on leaving. For the rest of us, therapy is a tool, not unlike disposable rollers and pans we use to paint our homes. Sometimes we save those tools for touch ups (maintenance). After a while, they get tucked out of sight, because we no longer need them. Eventually, we realize that keeping them is taking up valuable space that we could reclaim by discarding them. There comes a time in therapy (for most people) when the act of going to therapy begins taking away time from our lived experiences outside of therapy, and we choose to stop going.

Here are the six signs leading up to when you know you may no longer need therapy:

6. You know you may no longer need therapy when you’re managing life so well that you have to work to come up with an issue to talk to the therapist about.

In the beginning, it was hard to make it on my own between therapy sessions. At some point, to self-soothe during this time, I embraced the idea of choosing faith and releasing fear, deciding that no matter what happened, I would survive and be OK (without needing to know how). This was in addition to having chosen to live a life focused on gratitude and giving thanks on a daily (sometimes hourly) basis. These two choices remain amongst the most empowering and effective choices I continue to make for my mental health and well-being.

The only diet I ever tried that worked was a diet free from complaining.*

I decided to tell myself, “I’m safe,” whenever fear crept in. Through a practice of breathing through the discomfort until it passed, I came to believe that I actually was safe and whatever I was experiencing was transitory and no longer required 45 minutes of venting to a therapist each week.

After 10 years of practice with a therapist, I was finally able to process my emotions on my own, through the act of writing, walking, stillness, and prayer (to a non-religious God).

5. You know you may no longer need therapy when you find you are boring yourself by repeating the same drama each session, until one day, you finally make a bold move to create change. You do the thing you’ve been afraid of doing. All the things you were worried might happen actually do happen (more loss); but now, you’re living in truth, no longer hiding, and you have an elated sense of freedom (because you’ve learned how to process loss and aren’t being held hostage by fear). Suddenly, what was a recurring theme is no longer an issue, because you faced your greatest fear, took the necessary action, interrupted the pattern, and found a new way of moving through life that served you.

4. You know you may no longer need therapy when the main event that brought you into therapy resolves itself. For me, my greatest fear was dying before my child was an adult and leaving her care in the hands of another. Once she turned 18, I knew that her freedoms (depending on what part of the country, or world, she lived in) were her own; and 90% of my fears (anxieties) were instantly gone.

3. You know you may no longer need therapy when you fully grieve (process the “depression”) by forgiving yourself and others and letting go of the life you thought you’d have by embracing the life you’re actually living.

It’s easy to create the life of your dreams when you shift your focus from the life you think you want to the one you are making; maybe that’s the difference between a dream and an awakening.*

And the top two signs, the two actions I took that were most impactful to my life and healing, in knowing that I no longer needed therapy (which could be the signs you may no longer need therapy and may have to do with family) are…

2. You know you may no longer need therapy when you set boundaries for yourself versus others. I stopped blaming other people for their actions and took radical responsibility for my choices to put up with their actions.

I stepped away from transactional love, from relationships that lacked reciprocity: people who only reach out when they want something but who stay away if they think you are in need. I focused instead on the relationships built on the qualities my grandmother taught me, and it made a world of difference.

After one sibling-in-law accused me of “being too quiet” (which they interpreted as giving them the “silent treatment” and shutting down communication), I addressed each of their issues and was then accused by the other sibling-in-law of “sharing too much;” and that was the wake up call I needed to let go and move on. I grew tired of being the bigger person around people who are comfortable remaining small. ¹

I gave myself permission to stop trying with people who had no intention of ever embracing me, no matter who I was or what I did; I would never be enough for them.

I wasted so much of my life trying to be accepted by people who were never going to accept me; it took time, but I finally stopped crossing oceans for people who couldn’t be bothered to cross the street for me. I stopped listening to what people said and paid attention to what people did.

Once these people were out of my life, I realized I no longer had anything to talk about in therapy. Problem solved by removal.

I spent too many years trying to create corrective experiences with dysfunctional people in order to heal my past. It wasn’t until I completely stopped caring about their judgments that I finally set myself free.

The amusing, yet tragic irony, of being a writer who walks away from dysfunctional relationships is that the people you walk away from are so concerned about what you may write and publicly share about them that they start reading about you to hear about themselves; in the process, they inadvertently invest the time in the relationship that had they done from the beginning, likely wouldn’t have ended.

Cue Sly and the Family Stone singing, It’s a Family Affair and my favorite rendition of Que Será, Será (Whatever Will Be, Will Be). I’ve learned the hard way, rejection is protection.² I offered the olive branch of repair, they refused. Life goes on. Closing that door led me into a Willy Wonka moment that opened up a world of Technicolor leading me to number one on this countdown ...

1. … The number one way you may know you no longer need therapy is when you stop waiting for “someday” to make your dreams come true. I did the thing I never thought I could afford to do and it brought me happiness and satisfaction that was priceless.

After decades in survival mode, constant stress about money, and a looming threat of death from a medical diagnosis— a window of time appeared where everyone in my household was “healthy enough,” had the time to sojourn, and there were no active travel bans from the pandemic or personal life dramas requiring our full attention.

I took out a loan to prepare for my daughter’s education and my husband’s retirement, to work on a humanitarian project to end homelessness, to pursue some dreams, to enjoy living, and make some amazing memories.

I allowed myself to feel what was possible and released all judgments others might have of me for doing so, because this is my life that I’m living, not theirs (a simple truth we too often forget). I have zero regrets for taking this leap of faith. Those who sit in judgment do so from privileges I’ve never had; and until they experience the hardships I have, they will never have the empathy to know who I am or why I do what I’ve done. It’s not my job to throw pearls before swine and get judgmental people to comprehend something they are committed to misunderstanding.

Choosing to travel was one of the most liberating experiences of my life. I gave myself permission to live life on my terms, and doing so released me from the judgment of others that played a role in sending me into therapy in the first place (many of us end up in long term therapy to simply learn ways to cope with the family members who actually need therapy but refuse to go).

In Conclusion

I’m grateful for what I learned in therapy, and for the wisdom and compassion from the therapists I’ve worked with. I’m also grateful to reclaim my weekly time and live my life unencumbered by the issues that brought me to therapy in the first place. In three months of travel I didn’t think of or miss therapy once. When I returned home, it was as a fully integrated (albeit still imperfect human being), who was nevertheless at peace with herself and no longer thrown into a tailspin from any number of life dramas.

I spent a decade of practicing what I learned in therapy each week, and it helped me create the life I’m currently living: a life of love, fulfilling relationships, creative expression, relative health, laughter, wonder, joy, contentment, and yes, unfortunately, financial debt. In my defense, this is a time when the average cost of living is greater than the average living wage and few people are living debt-free. In fact, here’s a recent headline, Most Americans Don’t Earn Enough to Afford a Basic Cost of Living. It shouldn’t require privilege to live a life beyond that of survival.

Like any good book, therapy had a beginning, a middle, and an end. If ever I need it again, it’s there for me to go back to. For now, I place it on the shelf for someone else to check out.

I spent months working on the first sentence of the first book I had published and it’s the perfect end to my new beginning, “It’s not what we know that matters, it’s what we practice.”*

*quotes from Sage Words FREEDOM Book One

Sage Justice © May 20, 2025 www.SageWords.org This concept/theory/poem is original to Sage Justice. If you use it, please give credit and link to original work. Thank you.

Photo Image: Sage Justice, wearing poet’s black, walks away from the camera into the sunset on the rocky beach of Nice, France, just inches from the jade colored ocean waves. She is living her dream.

Sage Justice is an award-winning poet, author, critically acclaimed performing artist, and intensely sincere, bold humanitarian activist.

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Read the book FREEDOM ⭐️⭐️⭐️⭐️⭐️

1. Aphorism or platitude I read somewhere but have no idea who wrote it. Noting it here so as to not give the false impression that it’s an original thought.

2. Aphorism or platitude I read somewhere but have no idea who wrote it. Noting it here so as to not give the false impression that it’s an original thought.