Why We Stay: How Childhood Loss, Abandonment and Neglect Can Make It Hard to Leave an Abusive Therapist

There is one question victims of therapist abuse dread perhaps more than any other: “Why didn’t you just leave?” Of course, this question isn’t specific to victims of therapist abuse; it’s asked of anyone who’s spent a significant amount of time in an abusive relationship. I think we’re all guilty of at least thinking the question, whether or not we ask it out loud. We consider an abuse victim and wonder, How could this person stay with someone who’s treating them so badly? Why don’t they just leave? That anyone would tolerate abuse seems inconceivable.

An abuse victim who’s asked why they “didn’t just leave” an abusive situation is likely to experience an array of distressing emotions in response to the question, such as anxiety, anger, panic, confusion, shame and despair. Although it may be asked innocently (or, more likely, thoughtlessly) enough, this question pushes some big buttons. It implies that the victim was not only aware they were being abused but also had the strength, courage and power to leave the situation—and chose not to. As if the victim could have simply picked up and left at any time, but didn’t. (If it were as easy as that for the victim to leave, don’t you think they would have??)

This is one of those blame-the-victim questions that is not only extraordinarily shaming, it’s also unanswerable. Assuming that the victim even realized they were being abused, how could they even begin to explain why they could not leave? Most victims either do not understand or are incapable of articulating why they stayed, why they tolerated abuse, until well into their recovery process. And that may be years down the road. Anyone who asks this question and expects an answer is not simply being rude and insensitive, they’re also twisting the knife that’s already sticking through the victim’s heart. The only way for a victim to answer this painful question is to admit the depth of their powerlessness, fear, and feelings of worthlessness—in other words, what they are feeling most ashamed of.

Whether or not anyone dares to ask us the question directly, those of us who have been in abusive situations are likely to ask it of ourselves, as we try to grasp why we would stay in an abusive or exploitive relationship, why we wouldn’t  “just leave.”

The short answer to this loaded question is this: We don’t know how not to stay. For years we’ve been tolerating the intolerable in all kinds of situations. We stay in friendships that aren’t very friendly, jobs we dread, romantic partnerships that leave us feeling miserable and unfulfilled. Somewhere along the line, most likely in early childhood, we learned to accept what should have been unacceptable. We learned to stay.

Those of us with childhood issues related to loss, abandonment or neglect may have a particularly hard time leaving abusive and exploitive situations. Perhaps we lost a parent to death or divorce, grew up in an environment where there was alcohol or drug abuse, or had a parent who was angry, depressed or had a chronic illness. For one reason or another, as children we did not receive the care and attention we needed and this had a huge and lasting impact on our self-esteem, our outlook on the world, and the way we form attachments with others.

Let me give you the gist of how this can happen. When we’re young children, we need our parents’ love and undivided attention. We need their physical and emotional presence. If a parent is absent or physically or emotionally unavailable, we may believe that we are somehow to blame. We interpret their absence or lack of attention as meaning something personal about us. For example, we may believe we are unimportant or “not enough.” If we were enough, then the parent would be there with us. If we were important, then we would be getting our needs met. But we’re not getting our needs met. We begin to wonder: Am I worthy of attention? Do I deserve to get my needs met? Am I wanted? Am I lovable? We look for a reason that will explain our sense of disconnection from our primary caregiver. And the reason we come up with is us. And so we start to believe that we must not be “okay.” There must be something inherently wrong with us.

The more we doubt ourselves and our worth, the more our sense of self becomes shaky, unstable. We start to depend more and more on outside circumstances and other people to shore us up. Desperate for some stability, we search for ways to feel important, valued and get the attention and care we crave.

We try various tactics to get attention and prove our worth and “okay-ness.” Some of us act out, because negative attention is still attention. Others of us “act in.” We start changing ourselves, becoming less of this, more of that, in an attempt to become “better,” more pleasing, more valuable to others. In order to avoid any possibility of disappointment, rejection or abandonment, we suppress our “negative” feelings—anything that could prove bothersome to our caregivers—and we adjust our needs according to what others are willing or able to give. Perhaps we start to ignore our own needs and put more attention on the needs of others instead. If we give others what they want, if we take care of them, maybe they’ll value us more. Maybe they’ll give us the love and approval we need. Maybe they’ll stick around.

We learn to mistake people needing us and approving of us for “love.” When others need us, we feel important. When we take care of them, we feel worthy. When we receive approval, we feel validated. We believe these things mean that we are loved. The way we know love and find love becomes externalized, conditional on what we do instead of on our inherent beingness.

If we experienced neglect or abandonment in childhood, we may also struggle with fears of scarcity and loss. If we grew up believing that love and attention were limited resources, then we may feel compelled to take them when we can get them, in whatever way we can get them, from whoever will give them to us. When we find what feels like love or attention, even if it isn’t exactly what we want, we hang onto it, because what if that’s all there is? What if, without this, there is nothing? Out of our fear of loss and lack, we do whatever we can to hold onto what we have. We cannot afford to lose it.

For us, these are core existential issues we’re struggling with. If no one gives us the love, attention, or support we need, do we matter? Are we real? Do we exist? We want someone to prove our existence, validate it. Positive attention, negative attention—ultimately, it doesn’t really matter. As long as we’re getting some kind of attention, we know we exist. We know we matter. If the attention is positive, our feelings of worth increase. If the attention is negative, our feelings of worth decrease. But better that than nothing. When there is nothing, we feel invisible, immaterial. Unseen, unheard—like a ghost no one knows is there. Like everyone else is real except us. We live for any kind of validation of our existence. We need to know that we deserve to exist.

We hang onto people, possessions, jobs—afraid to let go or be without. We fear loss especially, because when we lose someone or something is taken from us, we see it as a sign that we’re not meant to have it, that we are simply not worth enough in this universe to have what we need. Loss and lack feel personal, a confirmation of our worst fears about ourselves. We are terrified that we deserve nothing.

If we suffered the trauma of abandonment as children, we may also develop a belief that leaving is bad, that “you don’t leave people you love.” Having been left, we don’t know how to leave. How could we put someone else through the kind of suffering that we’ve been through? We don’t want anyone to experience that aloneness. Instead, we stay.

And so we grow up and into our lives, continually looking outside ourselves for our sense of value and worth, for a sense of love. When we find something that fills this need—or even has the potential to fill this need—we have a tendency to become attached, dependent, addicted. It doesn’t matter if the situation proves detrimental to our physical, emotional, spiritual or even financial health. As long as the hope exists that we will get the love, attention or approval we crave, we hold on. We want so desperately to heal our childhood wound and have the experience of getting our needs met by a caregiver (or anyone remotely resembling a caregiver) that we tolerate situations others would run from and stay when others would leave. We do not want to give up the dream that this person will give us what our parent could not. We may spend years trying to recover what we lost or trying to find what we never had in the first place.

As a result, we seek to fill this longing for love, attention and approval in our friendships, romantic relationships, from our teachers and employers, and in particular from anyone who reminds us, in one way or another, of our parents.

Enter the therapist.

After years of wanting to feel seen, heard, cared for and attended to, now we get to spend an hour every week with someone who sees us, listens to us, understands us and values our well-being. Someone who focuses on us, and only us, for an entire therapy session. Someone who is completely reliable and will always be there. All we have to do is show up and give the therapist a check. We don’t have to take care of them or please them or try to be perfect. We can have our emotions—cry, get angry, be loud, be silly—and our therapist will not reject or abandon us. It’s a sure thing.

It may seem like an ideal relationship. And we may become very dependent upon it and very attached to our therapist. If the therapist has good boundaries and knows what they’re doing, then the relationship has the potential to be very healing and provide the support we need to work through our childhood issues and develop a stronger internal sense of self and value.

But if the therapist takes advantage of the situation by fostering our dependency on them and encouraging our attachment, then goes so far as to introduce their own needs and agenda into our therapy, we’re in big trouble.

Suddenly we find ourselves in a role reversal, once again caring for the caregiver. We fear that if we say no, we’ll lose their attention and earn their disapproval. We cannot let that happen, so we do what we’ve always done: We deny our feelings, repress our needs, and do our best to take care of the therapist. We believe that this is what it takes to get the “love” we want and keep people from leaving us.

If the therapist wants us to do things that make us feel uncomfortable, we can deal with that. We’ve learned to be tolerant. This is just one more thing we need to tolerate in order to hold onto what feels like love and care. We can handle anything in order to get that need met. Complying with the therapist’s wishes seems a small price to pay for their love and approval, for their validation of our worth and existence. Besides, this is our therapist—our teacher, our guide, our substitute parent. We hold them in such high esteem—of course their needs are more important than ours. They’re far more worthy than we are. We’ll do whatever they want in order to hold onto the “love,” in order to keep their approval. To lose the love of our “parent” again would be unbearable.

For some of us, being asked by the therapist to do things beyond the scope of the typical therapist-client relationship makes us feel special. After all, not every client is awarded this privilege, this honor. Taking care of the therapist gives us a sense of power and importance that we didn’t have before. Finally, we have a sense of being truly valued by the “parent” and having our worth recognized. We feel a sense of pride that they chose us. We may develop a profound sense of loyalty and devotion to the therapist for giving us this gift. Should they ask us to do something for them, of course we’ll say yes. Why would we say no? We feel indebted to them for making us feel more valued, more worthy, more loved. Now we just want to make them happy. We’ll gladly do whatever they ask.

Even if we do feel uncomfortable about some of the things that are going on, we still may not want to leave the therapist. We really want this relationship to work. First of all, we don’t want to give up the hope of getting our original childhood need met and having a restorative experience. As long as we stay, there’s a chance we can get the love and care we’ve always wanted. Things may not be so great right now, but that could easily change. What if fulfillment is right around the corner? If we leave, it will never happen. Can we afford to miss out on that opportunity?

If we’re suffering, well, surely any problems can be worked out. After all, our therapist cares about us, they want us to be happy. Maybe if we just tell them how we feel, they’ll realize that what they’re doing is hurting us, and they’ll change. Then everything will be the way it should be. Everything will be perfect. And we won’t have to leave.

We may also feel reluctant to leave if we blame ourselves for any “problems” in the relationship.  If we were trying hard enough, doing enough, things would be going better, wouldn’t they? Our own issues and inadequacies must be the source of the problems. After all, we’re the ones in therapy. We’re here because of our issues. The therapist, on the other hand, is a trained professional who knows what they’re doing. Someone we trust.  So, if something in this relationship isn’t working, isn’t it because of us? Shouldn’t we be willing to stay and commit to our therapy, do the work of healing and recovery? Isn’t that what we’re here for? Our fears and low self-esteem tell us that we’re the source of the problem—and that the problem needs to be “fixed.” Therefore, we should stay.

By this point, we may have become so attached to our therapist that we can barely consider leaving. We’ve been going to therapy once, maybe even twice a week—how would we function without our weekly sessions? Can we even imagine life without our therapist? We want so badly for someone to care for us and be there for us when we need them. Having that security is so important to us that we are willing to put up with pretty much anything in order to avoid losing it. Moreover, since we’ve sourced ourselves through the therapist, relied on them for our sense of value and self, leaving them would be like leaving a part of ourselves behind. Are we up for that sacrifice? That would take a strength and courage we may not feel capable of.  So once again, we decide that the solution must be to tolerate and accommodate in order to hold onto what we need. And that’s what we do.

From time to time we do feel a stronger urge to extricate ourselves from this situation. Maybe we’ve got a constant niggling feeling inside that tells us that something just isn’t right. Maybe we’re starting to feel resentful, angry. We question why we’re taking care of this person and feel reluctant to continue, especially if our own needs are suffering. Maybe we’re tired of paying money for therapy that isn’t really therapy. Maybe we find ourselves feeling so hurt and wounded by the behavior of our substitute parent that we simply can’t take it anymore. Maybe we know what the therapist is doing is wrong and we want out.

So one day we broach the subject. We work up the nerve (a feat that, in itself, could take weeks or months) and cautiously raise the issue of quitting therapy. Since the therapist represents an authority figure whose approval we rely on, we can’t actually tell them we’re going to leave, we ask permission to leave. We need to hear them say it’s okay for us to go, that they understand and agree with our reasoning. Even in leaving we need their approval. How many of us have spent hours trying to come up with what feel like legitimate reasons and justifications for leaving therapy—or even for simply saying no to our therapist? We’ll do whatever we can to avoid disapproval and the threat of abandonment.

Of course, an abusive therapist doesn’t want us to leave. They’re getting their needs met. Why would they give up a good thing? They have a vested interest in keeping things just the way they are. And they know only too well how to exploit our beliefs, fears, and longings to get us to stay.

First, they rationalize their own behavior, telling us that what they’ve been doing has only been for our benefit. Or maybe that it’s no big deal. Because we feel uncomfortable doubting them (surely the parent knows better than the child, right?), we’re likely to accept this reassurance. The child in us wants to hear that our suspicions are unfounded; we’d prefer to believe that the “parent” is competent, reliable, and trustworthy.

Then the therapist tells us why leaving therapy would be a mistake. We have so much to work on, they say—how could we walk away from all that? Besides, they would be so disappointed if we left. (Oh no, we can’t disappoint the parent!) Maybe they express concern at our ability to make it on our own, without their help. They worry about us, they say, and proceed to remind us of our limitations and shortcomings, thereby reinforcing our low self-esteem and undermining whatever belief we have in our own power. (If our therapist doesn’t believe in us, how are we supposed to believe in ourselves?)

Then they dangle the carrot: They tell us they can help us, that they can give us what we need, that they’ll always be there for us—as long as we keep coming to therapy and paying them. They remind us how well they know us and how much they care about our well-being. Ultimately, they reassure us, they’ll support whatever decision we make. After all, they only have our best interests at heart.

We want so badly to believe them! We desperately want the “parent” to take care of us, and we are utterly convinced that we’re defective and need help in order to finally be “okay.” Maybe we could just stick it out a while longer. So we let go of our fears and doubts and allow ourselves to be convinced to stay.

Even if our intuition is nudging us to leave, our bodies may have their own ideas. Perhaps we’ve become addicted not simply to the psychological “rewards” of complying with the therapist’s wishes but also to the hyper-aroused state we experience whenever they’re around, the neurochemical rush we get from physical contact. With the therapist, every experience feels heightened. Including the sex. Whether or not we actually enjoy the sex (or assume, from a dissociative state, that we do), sex with the therapist isn’t like sex with anyone else. We may experience a kind of euphoric high that we’ve never known before. The kind of intense physical, emotional, and perhaps spiritual bonding that occurs whenever we have sex with our therapist can produce a neurochemical cocktail that’s extremely addictive. Of course, we interpret this bonding response as love. And love means we stay. When the therapist is not around and our systems get a chance to recover, we may be able to imagine getting ourselves out of the relationship and moving on with our lives. But whenever we’re near them, in close physical proximity—and especially whenever we have sex—we find ourselves as bonded to them as ever. How can we wean ourselves off this addiction if we continue to be exposed every week? We can’t. We feel powerless to get away and may even blame our bodies for their “betrayal.”

If we’re the dissociative type, well, it’s easy to stay when some part of us has learned how to leave. We can be there without actually being there. If we’re not in our felt experience, do we even know that there’s a problem? Where we are, everything is just fine.

So we stay.

We stay until we are no longer getting the approval, validation and love we crave.
We stay until we’ve exhausted all hope that things will ever change, ever get better.
We stay until our repressed anger makes its way to the surface and we feel so enraged that we have to get out.
We stay until we finally feel so used, so betrayed, that we just can’t take it anymore.
We stay until the pain of leaving seems preferable to the pain of staying.
We stay until they tell us it’s over.

We stay because our belief in our own insufficiency tells us that this is all we deserve.

*  *  *

Childhood issues of loss, abandonment and neglect are by no means the only reasons we stay in abusive situations. How our histories and the beliefs we develop about ourselves make us vulnerable to abuse is a complex topic about which entire books have been written. Here I have offered a simple and fairly limited perspective. I do believe that, generally speaking, our vulnerability to abuse has much to do with boundaries and an underlying belief that we do not or cannot exist separately from others. When we grow up without boundaries, it can seem like the whole world has power over us. We don’t know where we end and others begin. Everyone seems to merge into us (or us into them) and we don’t know how to hold our own space. When we don’t have firm boundaries, violations can feel normal. And why would we leave a situation that feels normal?

Instead, we think we should stick it out, make it work. We believe that if we just do what we’re “supposed” to do, our dream of getting the love, care and attention we crave will finally come true. We will do whatever we can, exhaust every possibility, before giving up that dream, trying to avoid the loss of what we so desire. We may even have to be dragged away kicking and screaming before we’ll let go.

Still, whether someone else is asking us why we didn’t leave or we’re asking the question of ourselves, let’s keep one important point in mind: Our childhood issues and vulnerabilities are what brought us to therapy in the first place. We came to therapy for healing. We responded to abuse by doing the only things we knew how to do. We hadn’t yet learned to do anything different. And the one person we trusted to help us develop new, more effective responses and strategies not only did not do the job we hired them to do, but used our vulnerabilities and conditioning to exploit and abuse us.

How could we leave? In order to leave we would have had to value ourselves, feel some inherent sense of self-worth, deservingness, and personal power. But we never developed that strong, stable, core sense of self that would have reassured us that we were okay, lovable and worthy, able to stand up for ourselves and say no to abuse. We sought our validation from the outside, and the therapist, in one way or another, gave that to us. Why would we leave?

We need to realize that on some level we do have that self-worth and sense of internal value. Otherwise, we would never have recognized that something wasn’t right. Some part of us knew we were being violated and was trying to speak. But that inner voice had to compete with our longing for love and approval and attention. That’s a tough battle to win. It’s a testament to each of us—to our strength and to our growth, despite everything that was working against us to keep us small and quiet—that we were eventually able to hear this quiet voice and act on it. Going up against power and saying no to the “parent” isn’t easy. But eventually we did it. We took that first step and valued ourselves enough to leave.

With that first step, we began to heal. And that is more important than whatever came before it. So no matter what anyone else says or believes about us, let’s let ourselves off the hook and acknowledge our strength and courage in standing up for ourselves and finally breaking free.