The Hardcore Self-Help Podcast with Duff the Psych · Robert Duff, Ph.D.

421: Grieving your Therapist & Non-Suicidal Self-Injury

·26 min·1 clip

Duff says depression can feel like being "bone tired" and "almost soul tired."

1. The Hardcore Self-Help Podcast episode 421 addresses grieving a therapist and the physical symptoms of non-suicidal self-injury and major depression. 2. Dr. Robert Duff hosts the Q&A episode and answers two listener emails about ending therapy after anorexia treatment and about major depressive disorder. 3. The core question is how to cope when therapy ends and when depression shows up in the body rather than only in mood. 4. The first listener says the therapist was the first person who made her feel understood, safe, and comfortable opening up. 5. The listener describes crying for a week and feeling like she is "grieving the loss of someone who's still alive." 6. Duff says ending therapy is allowed to be hard, whether it ends because a treatment goal is met, a therapist moves, or a career shift changes caseloads. 7. He gives his own example of discontinuing almost half of his therapy patients after shifting toward testing, supervision of clinical interns, and outreach. 8. Duff says the therapist likely remembers the work, even if she forgets specific details like a mother’s name or the first eating-behavior episode. 9. He uses his graduate-school training clinic story to describe how a single breakthrough moment with a first patient can stay vivid for years. 10. Duff explains transference as redirected feelings from past relationships and countertransference as the therapist projecting personal feelings onto the client. 11. He says the listener may simply be grieving, not necessarily experiencing transference, and that grief can follow a breakup without any death. 12. Duff says the listener should expect time to help, because endings of emotional relationships often feel severe before they soften. 13. He then answers the second question by reading a quote from NSSI literature: "I cut to quiet the cacophony." 14. Duff says that quote captures depression’s tendency to make people feel disconnected from life and from their own self. 15. He states that major depressive disorder requires at least five symptoms for nearly every day over a minimum of two weeks, with depressed mood or loss of interest among the symptoms. 16. The listed symptoms include weight change, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, guilt, concentration problems, and recurrent thoughts of death. 17. Duff says depression-related fatigue can feel "bone tired" and "almost soul tired," not just like ordinary tiredness after work. 18. He says at least 25% of people with major depression also experience dissociation, including depersonalization and derealization. 19. The episode’s tone is supportive and explanatory, with Duff shifting between personal examples, diagnostic language, and practical coping suggestions. 20. Listeners who want grief language, depression criteria, and concrete grounding tools will get the most from it; listeners who want a light, fast episode may skip it.

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