The therapy vacation: what a break in care can yield

Many healthcare providers go on vacation in the summer. Peer support groups or other forms of support are also sometimes paused. If you have trauma symptoms, this can be difficult. Precisely during a period when symptoms can sometimes increase, therapy or support falls away. But could the interruption of care unexpectedly bring you something positive as well? Psychologist and trauma therapist Narda Miedema sees in her practice that a therapy break is often a valuable moment of reflection and processing, and can contribute to greater self-confidence and connection. 

If you trauma symptoms has, the summer vacation can be extra stressful. Your social network may be less available and for some people the summer also means a confrontation with people and places involved in the trauma. And what if this coincides precisely with the interruption of therapy or treatment because your healthcare provider is on vacation? 

In my practice, I see that people with trauma symptoms handle therapy interruptions in very different ways. That is logical, of course, because everyone is different and may be at a different point in their treatment. Some people immediately become a bit anxious, while others actually find the announcement of the therapy interruption very welcome.

Whatever someone's feelings and thoughts may be, the most important thing is that, as a client, you can openly discuss how you experience an upcoming therapy break with your therapist or practitioner. All your experiences and thoughts are welcome and must be taken seriously. In particular, the fear of losing a sense of connection can arise. This is a very normal reaction, especially when trauma symptoms are involved. It is important to talk about this; that is helpful for the therapeutic process and can often be a learning or reparative experience.

When discussing the upcoming therapy break together, it is the practitioner's job to provide you with clarity and transparency. As a client, you want to know whether someone else is temporarily taking over the therapy or treatment, and whether your practitioner can be reached during the vacation, and if so, in what way. It is also nice to know in advance what you can do during the therapy break to continue your process, which exercises or activities for regulation you can bet and when you will speak to each other again.  

Only when these conditions are met, a therapy break can also be a therapy vacation. A more positive experience that can contribute to recovery, hope, and resilience. By simply reframing a therapy break as a therapy vacation, your brain gets the space to make the switch from something that happens to you to something you have control over. The focus shifts from the absence of care (an experienced deficit) to the question of what a therapy vacation could bring you (an experience of growth).

In practice, I see that a therapy holiday can yield the following things—often unexpectedly for many people:

1. A valuable moment of processing and self-reflection

Trauma therapy is intensive because an incredible number of processes change in your brain, body, and heart (feelings). When changes take place, you also need recovery and processing time. In practice, I see that trauma therapy continues to have a strong impact in the week following the session, but processing also continues in the months that follow. A planned therapy break provides time and space to let processing take place and to give your brain, body, and heart the opportunity to find new places and new ways to store memories. At the same time, you can also continue to practice new behavior. As a result, behavioral patterns become more ingrained, and you can strengthen and consolidate new insights. In this way, there is often also more room for developing a sense of stability.

Also, during a therapy holiday you have the opportunity to look with more distance at the process you are going through during therapy or treatment. Pause for a moment to consider the changes that are already noticeable and palpable, however small. Or take the time to reflect on what you are already doing that helps well in dealing with the challenges of trauma symptoms. Precisely because you temporarily do not have therapy or treatment, more clarity often arises to see the big picture of your process. Which patterns that no longer serve you do you want to let go of more? And what should the focus of your therapy or treatment be after the break?

Regularly, many things also happen outside of therapy or treatment that have a positive influence on how someone is doing. Sometimes we forget how much those experiences weigh and we pin our recovery mainly or even entirely on therapy. In recent years, however, I have seen an enormous number of people recover due to factors outside of therapy, such as finding a new love, welcoming a pet, or practicing a new or old hobby. Therapy holiday provides space to reflect on factors outside of therapy that can make a lot of positive impact for you and often also literally gives more time to get started with them.

2. An increase in self-confidence 

Especially if you have been in therapy or treatment for a long time, an unconscious pattern can develop in which you might be somewhat quick to lean on the advice of your healthcare provider. For example, you then save up all the difficult moments or issues until the next session to discuss them and seek advice on them. In some phases of trauma therapy and with certain issues that is very appropriate, but it can also be the case that this pattern prevents you from (more actively) seeking out solutions on your own and from learning to trust yourself and your own judgment more.

During a therapy vacation, you are invited to do just that. Because what do you do at a difficult moment when your healthcare provider is not available? Or how do you handle a certain dilemma if you cannot discuss it during a session that same week? Although this may initially feel daunting, practice shows that many people during a therapy vacation actually discover that they are already capable of more and can handle more than they thought*. For example, you may experience that when you panic or feel anxious and your therapist or practitioner is unreachable, you start doing certain breathing exercises yourself that help you calm down. Some people also find out during a therapy vacation that they can ‘suddenly’ go to certain places or hold their own in certain conversations, even though beforehand they thought this would be much too difficult or that it was necessary to discuss it in advance with their healthcare provider. As a result, a therapy vacation can give a tremendous boost to your self-confidence and promote your recovery and healing. 

A therapy vacation diary

You can further support this process by keeping a therapy vacation journal. In it, you can write daily about positive experiences. For example, write an answer to the following questions: How can you tell that you are already feeling a little better? What are you proud of? What positive changes do you notice in your body? What do you spend your time on instead of therapy? 

Writing daily for a somewhat longer period about positive experiences gives the brain a anchor to keep activating positive thinking processes. Also, reading back through your therapy vacation journal can make you realize how much you can already rely on yourself. And remember that this can also be about small moments. Such as writing down that you enjoyed your homemade lunch, the pleasant scent of freshly cut grass that you noticed, or that you were able to be moved by beautiful music.

3. More connection with yourself and others

During a therapy vacation, you can be thrown back on yourself in a positive way. For some people with trauma symptoms, especially when attachment issues are also at play, the therapist or practitioner may be the only person to whom you can truly be honest (whether you feel that way or not). That can make a therapy interruption stressful, while at the same time offering opportunities. Because what do you do at the moment when you have no contact with your caregiver, but you have a strong need for connection, support, or a listening ear?

A therapy retreat can give you the helpful push to move through fear and discomfort and share more of your experiences with the people around you or to ask for support. For some people, this means that for the first time they are talking openly and honestly about their feelings or what they have been through with people other than their therapist. When you do this, you may discover that the people around you often understand more about how you feel than you had expected beforehand. As a result, relationships can deepen and you can begin to experience more connection. 

Sometimes you also find out that you would like to expand your current network. For example, because you don't have enough people around you. Or because your current contacts do not (yet) offer much room to show and share your vulnerability. Due to the temporary loss of contact with your therapist or practitioner, you often start to see this more clearly. That can be painful, but ultimately your heart will thank you for exploring your need for contact, and for stepping by step entering into new connections in which you can show more of yourself. In this process, you may also begin to experience more connection with yourself.

‘I didn't feel like a patient for a moment,’ someone once said to me after a therapy vacation. That is not a term I use for the people I work with, but her reaction very clearly illustrated how long-term care can make people feel like patients. Therapy, treatment, and recovering from trauma symptoms in general is an intense and often lonely process, during which all the other roles and traits you also have in life can become buried. A therapy vacation—although it is often the dead of heat in summer—can melt that snow, so that you come back into contact with who else you are.      

When a therapy vacation is used as a deliberate break from therapy or treatment, the space and distance that develops from your healthcare provider can be incredibly healing and empowering. Shall we continue to look and search together for the optimal balance between dependency and independence, within therapy, treatment, and other relationships?   

*What if a therapy holiday doesn't work out (as you had hoped)?

A therapy vacation can unexpectedly be an experience of growth for many people. But if this is not the case for you, know that this is completely normal and that you are not doing anything wrong. Everyone is different, we have all experienced different things in our lives and can also be at a different point in our healing or recovery.

The purpose of a therapy vacation is not for you to needlessly keep up a strong front. For example, if you feel anxious, very restless, or have thoughts of death, always reach out for help. Contact your healthcare provider if you have agreed to do so, or someone you trust. De Luisterlijn (The Listening Line), MIND Helpline, and the PsychoseNet Chat are also available all summer long for contact and a listening ear. And remember: next year your summer can be very different again.