“When It Doesn’t Feel Like a Happy Ending: Ending Therapy in the Midst of Uncertainty”

We often imagine the end of therapy as a success story: clarity found, wounds healed, the patient walking confidently into a brighter future. But not all endings feel like resolutions. Sometimes therapy ends in frustration, fatigue, or quiet disappointment. Sometimes the patient feels stuck, disillusioned, or emotionally flat. Sometimes they walk away not because they’re ready—but because they’re done.

In these moments, therapy hasn’t “failed”—it has arrived at a psychological truth that must be acknowledged, not denied.

When the Work Feels Stuck
There are times when therapy loses its vitality. Sessions feel repetitive, emotionally muted, or abstract. The patient might say, “It feels like we’re going in circles,” or “I’m not sure this is helping anymore.” Even the therapist may feel uncertain, unsure whether progress is still unfolding beneath the surface or if something essential has stalled.

This stagnation may reflect inner dynamics in the patient—a defense, a deep ambivalence, or a hidden hope that something outside therapy will shift first. But it can also point to a real breakdown in the therapeutic relationship. The trust that once held the process together may have frayed or collapsed. And when trust fades, it is often safer to leave than to stay and risk further disappointment.

Ending Without the Milestones
Some patients leave therapy without the external markers they hoped to achieve: a job, a relationship, a clear life direction. This can feel like failure—both for patient and therapist. But therapy is not a life-coach service or a solution machine. Its work is often deeper, and its timelines unpredictable.

The absence of resolution does not mean nothing happened. In fact, the decision to leave—even out of frustration—can represent a psychological movement. It may be an assertion of agency, a refusal to continue a process that no longer feels alive. Or it may be a re-enactment of earlier ruptures—leaving before being let down, withdrawing to preserve dignity.

The key is not to romanticize the ending, nor to shame it. The question is: What is being communicated by this ending? What does it tell us about the patient’s history of trust, hope, disillusionment, and longing?

The Therapist as Disappointed Object
In many therapies that end prematurely or in dissatisfaction, the therapist comes to represent a disappointed or disappointing object. The patient may feel the therapist has failed to understand them, push them, soothe them, or guide them. And sometimes, they are right.

But more often, these feelings mirror earlier experiences—parental figures who were inattentive, inconsistent, or emotionally unavailable. As Christopher Bollas (1987) notes, the therapist inevitably becomes a screen for these internal object relations. If the therapy becomes a place where nothing happens, this may echo a world in which desire itself was dangerous or unmet.

Even the act of leaving can be a form of protest: “I will not wait any longer for something that never arrives.” And this too is meaningful. It is not failure—it is communication.

Making Meaning of the Ending
When a patient leaves therapy without closure, it can feel like something was left unfinished. But unfinished endings can still have psychic value, especially if they are reflected on. They teach us about limits—ours and others‘. About the impossibility of perfect attunement. About the ways we defend against disappointment by shutting down hope. And about the human need to find meaning, even in messiness.

Some patients return years later—older, changed, carrying the memory of what was possible, and what wasn’t. And they pick up the thread from a new place. Others don’t return. But they carry something nonetheless: the trace of a relationship where their departure mattered.

Leaving Isn’t Always a Sign of Readiness—but It’s Always a Message
Leaving therapy when things feel stuck is not a failure. It is an act filled with unconscious meaning. Sometimes it is the only way the patient can assert control, protect hope, or mourn what never came. Our task as therapists—and as patients—is to stay curious about these endings, rather than reduce them to success or failure.

Even when therapy ends without clear change, it may have planted seeds: a shift in self-perception, a reworking of relational expectations, or even just the memory of being heard. That may not be the ending either party hoped for—but it may still be the ending that was possible.

References:

Bollas, C. (1987). The Shadow of the Object: Psychoanalysis of the Unthought Known. London: Free Association Books.
McWilliams, N. (2004). Psychoanalytic Psychotherapy: A Practitioner’s Guide. New York: Guilford Press.
Ogden, T.H. (1994). The Analytic Third: Working with Intersubjective Clinical Facts. International Journal of Psychoanalysis, 75, 3–19.