Exactly What to Do When You Need an Appointment With the Therapist You Ghosted

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"Why are you the way that you are?" is a Michael Scott-ism that I ask myself almost every day. Usually it's because I'm doing something like ordering tacos for the third night in a row (instead of cooking my fresh groceries) or binge-watching Love Island (instead of, oh, I don't know, reading a book). But the other week, it was because I was facing crippling anxiety about therapy, because I had essentially ghosted my therapist and needed to make an appointment.

I was way overdue for a visit at this point and needed to see my psychiatrist because I had run out of refills on my anxiety medications, thus perpetuating said anxiety. Beyond that big-deal reason for my anxiety uptick, though, I worried he would judge me, or tell me to find someone else out of frustration for my lack of compliance, or straight up just not respond to my request for an appointment. I wondered if I might be better off just seeing someone new, but didn't really want to go that route, because finding a mental-health professional who fits your needs is hard, and I really liked this one.

Well, one thing I had going for me is being in good company because therapist-ghosting is actually relatively common. Psychologist Laura Athey-Lloyd, PsyD, notes that studies and meta-analyses have found, repeatedly, that premature therapy dropout happens often. "The reasons for ghosting vary based on when in the therapy the ghosting takes place," she says.

If someone ghosts after the initial intake call (so never makes it to the first actual session), for instance, they were probably ambivalent about starting therapy and were embarrassed to admit that they felt anxious about it. "Ghosting after a first session may have more to do with a mismatch between client and therapist," Dr. Athey-Lloyd adds. "Some therapists may be experienced as too pushy, asking too many questions, or delving too deeply too soon. Other therapists may be experienced as too passive, not asking enough questions, and [being] unhelpful. The way a client perceives a therapist is so individual and may have as much to do with a client’s interpersonal history as with the therapist’s actual style."

"This often occurs in the context of a positive relationship, but one where the therapist is not asking, 'How is this working for you? Are we meeting your goals? Is this still feeling helpful?'" —Laura Athey-Lloyd, PsyD


And then there are those, like me, who ghost after months—or even years—of regular appointments. "These clients usually report that they loved their therapist and benefited greatly from the therapy (hence why they stuck around), but felt anxious bringing up directly that they were ready for a break, for either financial or personal reasons," Dr. Athey-Lloyd says. "This often occurs in the context of a very close and positive working relationship, but one where the therapist is not asking questions like, 'How is this working for you? Are we meeting your goals? Is this still feeling helpful?'"

So, to address my specific fears and anxiety about therapy ghosting, I asked what the pros tend to think when it happens. For Dr. Athey-Lloyd, it's mostly just concern for the patient's well-being and regret about missing out on closure. "When a client is proactive in telling me that they wish to end therapy, we usually plan one more session to review their progress as a whole. That final session is always such a powerful experience, and clients leave feeling very proud of themselves. It’s a shame to miss that opportunity," she says.

And then, as if it's my lucky day, she tells me exactly what I want to hear regarding my anxiety about therapy ghosting. "I would love to reassure anyone who feels this way that this happens all the time. I’ve had many former clients who left, either through ghosting or by way of a planned ending, who return, sometimes years later," Dr. Athey-Lloyd says. "I am always happy to see them again, curious to hear about what’s been going on in their lives in the meantime, and eager to jump right in to help with whatever is coming up in the present."

So, if you've ghosted your therapist and want to go back? "Don’t let awkward feelings about how things ended stop you from resuming a former therapy relationship that was helpful. It’s likely to be helpful again, and you won’t have to start over from the beginning," Dr. Athey-Lloyd says. And if it's not working and you don't want to go back, it's okay to let them know that as well. Remember, this is a professional relationship with the express purpose to offer a service to you, the patient. And, you know yourself best.

Now that you can quell your anxiety about therapy and your therapist, here's a guide on breaking up with your therapist, guilt-free. And here's how to recover from your post-therapy blues

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