Advice please: Coping with long distance therapy

In a few weeks I am going to be moving out of my current home. This means I am also moving away from my therapist. The idea of finding a new therapist closer to where I’ll be hasn’t really crossed my mind, because I’m incredibly attached to J and I can’t imagine trying to work with someone new at the moment.

There are a lot of things I love that I am leaving behind for this move. My wonderful colleagues, the places I like to walk with the dog, friendly neighbours, a cosy house, and a day to day routine that makes me feel secure. Letting go of these things is hard, and it’s scary. But none of that is as scary as putting a commute of several hours between myself and J.

At the moment, J and I live in the same town. I can walk to her house in 25 minutes. But it isn’t about that convenience. What’s tough is the thought of not being near her anymore. I get a sense of safety and reassurance from knowing she’s not far away. It’s oddly comforting that we inhabit the same places. It’s like we have something more in common than the therapy. I feel tearful and worried when I think about losing that.

It’s hard to even talk about this with J, because it is so emotionally charged for me. But I did bring it up last week, and I was surprised when she said she’ll miss the very same thing. I hadn’t realised it means something to her too; being able to picture the places I am in and imagine where I am wandering about. I appreciated her sharing that with me.

What makes it all more difficult is knowing that I will lose a significant amount of my contact with her as well. In January, we already reduced from 3 session per week to 2, because of her changing what she’s doing. That was a huge deal for me, and I still struggle with missing her on Thursdays when I’d usually see her. When I move, I’m not going to be able to see her more than once per week. It’s hard to even think about that right now.

When we spoke about it last week, J suggested I think about what I need to make the transition easier. She mentioned that we could do a single 2 hour session. Or an hour in person and a session on Skype (although I think that’s not going to be workable with the technical limitations of living on a boat). She also said we could set up some email contact for a while.

I’ve only come up with one idea so far and I’m not even sure I could ask for it. I thought maybe I could ask J to give me a ‘transitional object’ to keep at home with me. I often find it comforting to borrow a blanket from her when I’m struggling to feel connected. But I thought maybe if I gave her the money to buy something for me, that would be even better. It would be something she has thought about and that comes from her, that I can look at or hold when I want to remind myself that she cares. However, it does feel impossibly hard to ask for this.

The problem is really that I can’t imagine anything will make this feel less distressing. So I wanted to ask for some advice / suggestions from others who might have had to manage the same kind of thing.

I’d love to hear your thoughts if you’re doing long distance therapy. How was the change for you? What did / didn’t help make it work?

Any input would be much appreciated, because right now I feel worried and super scared about it.


Photo: Robert Couse-Baker, Creative Commons.


13 Comments Add yours

  1. easetheride says:

    Hi Laura, I like the idea of a transitional object. Do you think she would be amenable to writing you a letter that could possibly be used in a transitional manner? Something you can read to remember kindness and get the support you need when you’re having trouble internalizing it yourself. I understand your reluctance to ask, but I don’t think it’s out of the realm of normal to need something like that with such a huge shift in the structure of your working relationship with her. Regarding sessions, if you are unable to facilitate a Skype session, perhaps J would be willing to do 1 or 2 phone check-ins during the week, maybe 10-15 minutes in length? I don’t know if your phone service is any better, but these could perhaps serve as boosters to get you through. I feel for you, I’m sure this is so difficult to even think about.

    Liked by 1 person

    1. Laura says:

      Thanks for your input. She does write me a note when she goes on holiday, and it helps to have that. But I tend to find what I get from the notes is a bit temporary. When she’s on leave I try not to open them until I really need them, and I think they work because I save the ‘contact’ for when I’m struggling – rather than re-reading them all the time. But maybe phone check ins would work. It’s hard to feel like anything is going to make this easier at the moment.


  2. KJ says:

    Are you in the kind of relationship where you could text or call her once a week, between sessions?

    For a long time I emailed my psychiatrist every 3 days with a journal. He wouldn’t send a big response but just knowing he was there was a big help.

    Liked by 1 person

    1. Laura says:

      I think it might be an option. I generally feel more comfortable emailing, as I’m not at all used to speaking to her on the phone. I’ve only done that in times of crisis before. But perhaps I’m going to have to push through that fear about doing something different.

      Liked by 1 person

      1. KJ says:

        Emailing was such a help. I only see him every 3-4 weeks but knowing he’s always happy for me to email him (I have his personal email too) if things get hard, is such a net safety net.

        Liked by 1 person

  3. DV says:

    I’m not speaking from any experience of long distance therapy, but there are small things which I do to maintain the feeling of connection and shared experience with family who live in another country. J saying that she will miss the same thing as you, that sense of being part of a *shared* place and routine, made me wonder whether having a transitional object that is just something from her to you might not be enough and whether it needs to something more shared or something you both have (or do) that is the same and which is part of your everyday lives so that you feel as if she is thinking of you as well as you thinking of her.

    What works for you will be different from what works for me, but to give some examples of the sort of things which I found helpful: my brother and sister and I all have identical mugs and I buy a brand of biscuits which are from there, so when I have tea and biscuits it gives me the feeling not exactly of sharing it, but at least of having a similar and parallel experience; when I check the local weather forecast I check the one for their city as well; and my sister and I read the same advice column and we sometimes discuss the comments, and now whenever I read it I can imagine her reaction as if we were actually talking. They seem like such tiny and silly things when I see it written out, but they do make a difference.

    Liked by 3 people

    1. Laura says:

      They don’t seem like silly things to me at all. I can absolutely see the value in sharing them. It’s almost like you’re doing something together then. I remember a few years back when J was away we said we’d do yoga ‘together’ in the same way. I liked how that felt. It’s an interesting idea, but something I’ll definitely think about – thank you!

      Liked by 2 people

  4. Hey! I just came across this post, and wanted to comment, because I am the long distance therapy queen (not to blow my own horn haha – I just mean, been here, done this, absolutely got the t-shirt.. and the transitional object!)

    I started working long distance with my therapist in May 2017, so weirdly enough we have been working long distance for… about the same time that we were working close together. For me, it happened extremely suddenly – I lost my job, then lost my home in the same week. I went to see him one last time, then… went and took a train back to my hometown, 100 miles away. I had no idea what was going to happen, just that I knew I didn’t want to lose my relationship with Tom. And we made it work!

    So, what helped:

    1. PLANNING – you’ve got that on your side here, as you have pre-warning and time! You guys can make a plan of how your sessions are going to look moving forward. HOWEVER, bear in mind that obviously you don’t know for certain how it will look and feel until you’re living it, which brings me onto point 2…

    2. Being OK with trial and error – the first month I moved away, me and Tom just spoke over the phone 2/3 times a week. That was not ideal, in retrospect, but it kept the connection alive while we worked out what was next. Since then, we have settled into a pattern – I go and see him on Monday (which is usually a longer session due to the long trip), we speak on the phone on Wednesday (either before or after work), and we do a Skype session on Friday (I taught him how to Skype!). For me (and him) this works really well. But only over the past couple of months have we settled into this routine. You WILL find one that works for you, if you are both willing to work at it. It definitely makes therapy harder, but NOT insurmountable.

    3. Transitional object – to me this is a definite yes, if you can bring yourself to ask. I have a ring that I wear every day and it’s nice to have a reminder against my skin that he is always around. As you said, you’re even willing to give her money to get you something. I would really push for this if you can, I think it’s a real help and it definitely helped me at first.

    Cool things about being long distance – you mentioned you’ll miss being close, and being part of the same environment. But actually, I feel closer to my therapist now than I ever did when I was 15 minutes from him. I really do. Because we have to work to fit in sessions around both our schedules in a different way, I feel like I have more of a sense of his life and his rhythms. Like, I know he can’t Skype Friday evenings, because he’s at a martial arts class. And OK, maybe he didn’t have to tell me what the commitment was, but he did, and I like that. I feel like I have a much better understanding of his schedule since we went long distance. There are other little things like that (Thursdays are always a no-no for him, he works Saturdays) that give me a sense that I understand his world better now. He has Skyped me from his home sometimes, so I get a tiny glimpse of his world (as much as you can see in the little Skype window anyway).

    Plus, with Skype, you can make a screenshot of their face smiling at you and carry around in your phone to look at when you feel bad… 😉 haha, don’t worry, he knows I did this! Genuinely does help though.

    I don’t know if you are someone who shares any physical contact with your therapist, and this is something I do miss – for me, this is the major thing that makes Skype worse than an in-person session. I would say that once you get used to Skype, bar the idea of physical touch, I don’t even find there to be a difference anymore. We are so comfortable with one another, and it gets more intimate in some ways – like, I’ll get up late and Skype him in my dressing gown if I’m feeling sick or tired. In a weird way, you share more of each other’s worlds. I even saw his Christmas tree!

    I think making the leap to long-distance proves a commitment on both ends to the work. I think that is a really powerful thing. It has emboldened me and made me certain of my therapist’s care for me – it is no longer merely an arrangement of convenience on either end.

    Anything you want to ask, please don’t hesitate. Good luck with this – it was a big shock to the system for me, but I got used to it so quickly, and I am honestly 100 times closer with my therapist now than I was before I moved away (and he completely agrees it has made us closer too!)

    Liked by 1 person

    1. Laura says:

      Thank you so much for taking the time to share your experience with me. It’s really good to know that the distance can have a positive impact, that hadn’t even crossed my mind! I’d just assumed it could only make things worse.

      It’s also helpful to be reminded that it’s going to be trial and error for a while – and I can work on being OK with that. I don’t need to find a perfect solution right now before I move. We’re going to have to feel our way through it to find out what works. Like you say, as long as we are both willing to work on it together, we’ll figure it out.

      Liked by 1 person

      1. I would have thought exactly the same. But genuinely, for us, it did have a positive impact. I’m not saying it will be the same but I think it’s great to know that it can work out that way and it isnt necessarily the blow you might be expecting!

        Liked by 1 person

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s