Trying to Leave the Space
Clients may express the desire to leave the therapy space for several different reasons.
When this occurs, health professionals should remind clients that one of the foundational agreements that they made for the session was that they would not leave the therapy room until the session is complete and that leaving the clinic is not an option. Health professionals should communicate that this agreement must be maintained for the client’s safety. It can be helpful for the health professionals to have a statement to this effect practiced and they may need to repeat it many times.
I understand that you want to leave, but this room is a safe space, and we are going to stay here and work through this experience together.
I understand you feel afraid, and together we will work through this, and together we are going to stay in this room where it is safe.
Applying Inquiry
With this, it will likely be important to explore why it is that the client wants to leave, where they want to go, and what they think might be different if they were able to go home or somewhere else. The information that arises from this inquiry can help the health professional to know how to best reassure the client and address any concerns they may have. The client’s comfort and safety are a priority here and if there is anything that can be done to improve these aspects of their experience, it should be acted upon.
Changes to the Therapeutic Relationship
If the circumstance arises where the client becomes uncomfortable with the presence of their health professional, then efforts should be made to have someone else from the clinic join the session or to see if their support person may be available to join and help to reassure and support them.
Health Professional Tip
If the client gets caught in a loop where they are resisting the experience (as described previously) and wanting to leave because they feel it may change their experience or make it stop, are there any alternatives to leaving the therapeutic space?
It may be helpful to ask them to remind themselves of their intention and why they are participating in this therapy program. Sometimes the impulse to leave may also represent the emergence of trauma-related sympathetic hyperarousal. It may be helpful to be curious and inquire with the client if they notice any sensations in their legs, and to help them sequence through slow movements flexing and releasing the leg muscles or imagining seeing themselves running in their mind’s eye – it is often helpful to help them choose an imagined safe destination to run to prior to this visualization.
These interventions may lead to a supportive discharge of previously held survival energy. At times, a planned distraction may also be helpful, such as drawing their attention to something interesting in the room or offering to spend a little time leading them through a guided meditation such as a body scan.
With the exception of a fire alarm or emergency (as we will discuss shortly) there are no circumstances within which a client may be allowed to leave the clinic. Any attempt by a disoriented volunteer to leave the site should be met with compassionate but firm direction to stay within the session room.
References
Haden, M. (2019). Manual for Psychedelic Guides.