What happens when your therapist ghosts you?

Finding the right shrink is a lot like dating, what with the mandatory mismatches we endure before meeting The One. Tamika Smith lucked out, avoiding the trial-and-error process completely. After a lupus diagnosis led to a loss of mobility and livelihood, a family member introduced her to what she called an “all-star” therapist. “I connected with them quickly, and felt safe and heard. We built this very easy rapport within the first three sessions and had a treatment plan lined up. I was very lucky,” she tells Dazed.

But like any guys off the apps, even mental health professionals can ghost their patients. Following a routine session, Smith hadn’t heard back from her therapist for days and went back and forth with their receptionist trying to get an explanation. To this day, she doesn’t know what happened. “I was already so exhausted from fighting to live, adjusting to life without the ability to walk, and constantly advocating for my health. I knew I had to move on,” she said.

Unfortunately, this is far from an isolated incident. A quick scan of Reddit forums, X posts and even podcasts reveals how often therapists disappear without warning, leaving their patients to wonder what went wrong. Some get their assistants to put off appointments indefinitely until patients grow tired of waiting, while others simply don’t answer the phone. 

According to researchers at Columbia University, when terminating a psychotherapeutic relationship therapists should “enact a series of clinically, ethically and practically appropriate steps that are attuned to the needs of the patient”. They define ghosting as “inappropriate termination”, in violation of several general principles of the profession’s code of conduct: beneficence and nonmaleficence (extending kindness and minimising harm to others), fidelity and responsibility, and integrity.

This behaviour is cruel enough coming from ex-best friends or former lovers. But as trauma and family wellness therapist Briana Sefcik tells Dazed, “therapy is supposed to be a space of trust and healing, so being ghosted by someone who has seen you at your lowest and knows that you are in need of assistance can be heartbreaking. The experience can be so terrible it can make one question whether therapy is even worth it.” 

As a result, patients often ruminate and come up with worst-case scenarios. According to the study conducted by the aforementioned Columbia researchers, 21.3 per cent of patients who were ghosted by their therapists believed they were ghosted because “[their therapist] didn’t like them or found them to be a difficult client”. But Sefick insists that it’s not their fault, but a reflection of the therapist’s ability to deal with existing circumstances. For instance, after a few conversations, therapists may realise that they do not possess the expertise needed for their client’s specific issue. 

The thought of searching for someone new, going through the intake process, and opening up all over again was so overwhelming to me

Many ghost because they’re also just human, fallible people. “The truth is, the work they do – listening to and maybe even internalising others’ pain – can be incredibly draining and can take a toll,” Sefcik explains. On top of that, they normally work in “underfunded systems” with long hours, overlapping schedules, and barely any support for their own well-being. In an anonymous survey of faculty and trainees in clinical, counselling and school psychology, more than 80 per cent said they had experienced a mental health difficulty at some point in their lives, and nearly half said they’d been diagnosed with a mental health condition. 

Ironically, the field of psychology stigmatises such professionals. There’s this unwritten agreement that going through mental health struggles “[colours] one’s work and makes them unable to properly carry out their duties or conduct objective research”. Many refrain from revealing this crucial aspect of their identity, which could lead to social isolation, depression and anxiety (I’m reminded of a chilling painting by PQHAÜS titled ‘My therapist killed himself and now I don’t know what to do’, which depicts a patient chained to a chair containing only an urn and an unsolved Rubik’s Cube).

Mac Gillihan initially bonded with their therapist over a shared bipolar disorder diagnosis. But what Sefcik describes as “this pressure to have it all together” might have got to her. “There were times during sessions when she would get distracted. I would finish a thought then we would sit in silence, as if she was playing off her absentmindedness as a sign that she was waiting for me to continue,” Gillihan told Dazed. When she eventually ghosted, they were disappointed but not surprised: “I’m assuming there was some sort of family emergency, because I knew she was dealing with those issues at the time, so I couldn’t be too upset.”

Of course, this is still not an excuse. One disillusioned Reddit user said it best: “It takes less than a few minutes to contact someone and tell them. They don’t have to explain what’s going on in their lives, just that they can no longer continue therapy.” Therapists must not only give closure but also offer referrals to other resources, so clients don’t have to start from square one.

As for grief-stricken patients, it’s understandable to feel hurt or discouraged. “After being ghosted, it took time for me to start over because my capacity was limited then,” Smith shares. “The thought of searching for someone new, going through the intake process and opening up all over again was so overwhelming to me.” 

While the most common advice is to just look for someone new, as if we’re dealing with a failed situationship, Sefcik encourages patients to take their time. After all, without the safety net of workplace benefits, scouting for a new shrink isn’t affordable. “Process what happened in whatever way you see fit, whether it’s by talking to someone you trust or writing about your feelings.”

Once we’re ready to move forward with someone new, take note of clear signs of compatibility. “A good therapist will make an effort to set expectations about how they work, what their policies are and how they handle scheduling or emergencies,” Sefcik says. 

Be proactive and ask questions about their availability or standards for terminating a relationship. “I think a lot of my issues with my therapist stemmed from a fear of speaking up,” Gillihan admitted. “Now, I feel more equipped to be upfront with my future therapist about any issues I have with the sessions. I would be more able to verbalise what is or isn’t working for me.”

At the risk of sounding too earnest, the key to fully overcoming this rejection is by believing that we are worth the fight. Smith eventually moved on to a new therapist, whom she has been seeing for almost four years now, and has seen major strides in her personal growth. “I could have easily resented [the idea of] therapy after my experience. But I had to remind myself that I deserve someone who aligns with my needs. I deserve to be helped.”