Studies show that 36% of clients ghost the therapist within 1-week of a vulnerable therapy session. I almost threw away my best chance at healing when my therapist saw through my defenses. Didn’t know that classic relationship sabotage could extend to the therapist’s office.
Ghosting My Therapist
I’d been seeing Dr. Parker for exactly six sessions when she leaned forward and said the words that made me ghost the therapist: “I notice you share plenty of stories about other people, but almost nothing about yourself.” The observation landed like a diagnosis I wasn’t prepared to hear. I smiled politely, promised to think about it, and canceled my next three appointments via text before blocking her number entirely.
According to research from Oslo DPS, I wasn’t alone in my vanishing act. A comprehensive 2023 study found that 25.3% of therapy clients drop out prematurely, with an alarming 36.1% simply disappearing without formal termination, essentially choosing to ghost the therapist rather than have a difficult conversation (Hanevik et al., 2023).
Even more telling: dropout occurred most frequently between assessment and the first session (20%) and between the fourth and fifth sessions (21.8%) right when therapy begins to tackle core issues rather than just collecting background information.
Why We Disappear When Therapy Gets Vulnerable
The irony isn’t lost on me: I sought therapy to fix my relationship patterns, then recreated those exact patterns with my therapist. Researchers have identified several key moments when clients are most likely to ghost their therapist:
1. When Your Therapist Calls You on Your B.S.
Dr. Jessica Benjamin, psychoanalyst and attachment theory researcher, explains that “being accurately seen by the therapist can activate the same threat detection system that emotional intimacy triggers in personal relationships”. When my therapist accurately noticed my emotional withholding, my brain interpreted her insight as danger.
The Hanevik study confirms this pattern, noting that clients most frequently ghost the therapist precisely after sessions where meaningful therapeutic work begins typically around session 4-5 when surface-level issues give way to deeper patterns.
2. During Vulnerability Hangovers
A longitudinal study from the Queen Mary University of London found that 67% of clients who ghost their therapists do so within one week of a particularly vulnerable session (Windle et al, 2020). The “vulnerability hangover” triggers overwhelming shame that only disappearing seems to solve.
Researchers categorized this as “transference and attachment issues” , clients projecting past relational wounds onto the therapeutic relationship and fleeing when those wounds feel exposed (Paivio and Pascual-Leone, 2010)
3. When Therapeutic Attachment Forms
“The most painful paradox for fearful avoidant clients is that they ghost the therapist precisely when the therapeutic relationship becomes meaningful,” explained in Psychotherapy written by Dr. David Wallin, a private practice clinical psychologist in Albany and Mill Valley, California.
The statistical realities shared by Dr. Otto Smith’s group is sobering: the average dropout client attends only 2.36 sessions, while completers average 7.37 sessions. This means most clients who ghost the therapist leave before the therapeutic process has truly begun.
The Normalized Epidemic of Therapy Ghosting
The phrase “I need to ghost the therapist” has become so common that clinicians have developed specific protocols for handling it. Between 20-57% of clients don’t return after their initial appointment, according to multiple studies synthesized by the American Psychological Association (Swift & Greenberg, 2015).
“The most common way therapy ends is by the client ghosting,” confirms clinical psychologist Dr. Janina Fisher. “This is especially true for clients with histories of attachment trauma, who haven’t experienced healthy endings in other relationships” (Fisher, 2018).
Particularly telling from the Oslo research: therapists reported “not being able to contact the client” as the leading reason (36.1%) for therapy termination among dropouts more than lack of motivation (19.5%) and dissatisfaction with results (4.5%) combined.
The Neurological Explanation
For those who are likely to ghost the therapist, some neurological differences are observed in individuals who were diagnosed with conditions like antisocial personality disorder and psychopathy, which might be relevant to the dynamics of therapy and their likelihood to remain in psychotherapy. Brain scans have shown structural and functional variations in the brains of people with these conditions, including reduced volume in certain areas like the middle and orbital frontal gyri, and alterations in the amygdala. When therapeutic relationships deepen, two contradictory brain systems activate simultaneously:
- The attachment system (seeking connection)
- The threat detection system (signaling danger)
This simultaneous activation creates what neuroscientists call an “approach-avoidance conflict,” where the brain literally cannot determine if connection is safe or threatening (Quirin et al., 2017).
In practical terms, this means when my therapist began to dig deeper to the root of my relationship anxiety, my brain simultaneously screamed “Uh oh! She saw me!” and “Run!” The resolution to this conflict? For many the answer is still to ghost the therapist and eliminate the neurological dissonance.
Breaking the Ghosting Cycle
After ghosting three different therapists over four years, I finally managed to stay in treatment using these counterintuitive strategies:
Pre-emptive Ghosting Discussions
Research from Columbia University found that clients who explicitly discussed the possibility they might ghost the therapist during early sessions were 43% less likely to actually disappear (Diamond et al., 2020). Naming the pattern defuses its power.
Now, I am open about my therapy history and I began my next therapy relationship by admitting, “I have a history of ghosting therapists when things get uncomfortable. Can we talk about what to do if I feel that urge?” I wish I could be that open with the people I date.
The 24-Hour Rule
After moving on to another therapist, the urge to ghost the therapist struck AGAIN, but this time I committed to waiting 24 hours before acting. The Oslo research reveals that simply extending the decision-making window can significantly reduce impulsive termination decisions.
This aligns with what therapists identify as a crucial intervention: giving clients space to process difficult therapeutic moments before they make termination decisions.
Finding a “Ghosting-Informed” Therapist
I specifically sought therapists familiar with attachment-based approaches who normalized rather than pathologized the impulse to ghost the therapist. My current therapist even uses the phrase “I see your ghost is visiting today” when she notices my withdrawal.
The Oslo study highlights that poor social support (reported by 32.5% of participants) correlates with higher dropout rates. A therapist who understands attachment dynamics can function as crucial relational support during the vulnerable moments when ghosting impulses peak.
The Critical Fifth Session Threshold
The Oslo research also revealed a fascinating pattern: the highest risk of ghosting occurs between sessions four and five (21.8% of all dropouts). This aligns perfectly with my own ghosting behavior, which typically occurred around session 5-7.
Why this specific window? Therapy experts explain that the first 3-4 sessions typically focus on history-taking and rapport-building. It’s around session five when therapists begin challenging defense mechanisms and addressing core attachment wounds precisely when the urge to ghost the therapist intensifies.
Knowing this pattern exists helped me recognize my ghosting impulse as a predictable phase rather than a reason to actually disappear.
Going Back to Your Therapist After Ghosting
Six months after ghosting Dr. Parker, I sent an awkward message through her app explaining my disappearance. Her response changed my understanding of the therapeutic relationship: “When clients ghost the therapist, I see it as a difficult decision that was made related to their attachment patterns. Your return is the most important part of the process.”
Research confirms this perspective, showing that clients who return after ghosting often make significant therapeutic progress (Talia et al., 2020).
How to Start Over When You’ve Ghosted Your Therapist
If you’ve disappeared from therapy and are contemplating return, try these approaches:
- Email/message them rather than call this can reduce emotional intensity
- Focus on the pattern rather than apologizing excessively
- Recognize that returning after ghosting is actually a sign of growth
As Dr. Parker told me during our reunion session: “The fact that you ghosted and came back tells me more about your capacity for healing than if you’d never left at all.”
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