Pains and gains: a study of forced terminations.
The forced termination of psychoanalysis, such as occurs when the analyst makes a geographic move, uniquely disrupts the analytic setting. This paper recounts the author's experience of terminating a full-time private practice of psychoanalysis and psychoanalytic therapy for such a move. The limited literature on the subject is reviewed with a focus on the use of technical variation in the forced termination situation. The author delineates three areas of interaction with patients where technical variation proved in her experience to be of value: dealing with countertransference and counter-reaction, providing information about the move, and the consideration and process of referral for continued therapy. As opposed to what would be predicted from a classical psychoanalytic perspective, the use of such technical maneuvers seemed to facilitate rather than impede analytic work. These variations in technique served at crucial times to maintain the analytic alliance, to preserve the patient's capacity to recognize and make use of transference, and to provide avenues for resolving past traumas in the transference and the actual loss of the analyst. The concept of the analyst as a new or useable object is proposed as providing a theoretical framework for understanding these observations.
Martinez
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Department of Psychiatry, University of Texas Health Science Center, San Antonio.
D000223:Adaptation, Psychological; D003379:Countertransference; D004325:Dreams; D004532:Ego; D006801:Humans; D011369:Professional-Patient Relations; D011574:Psychoanalytic Theory; D011575:Psychoanalytic Therapy / Q000379:methods*; D011936:Reality Testing; D012017:Referral and Consultation; D012059:Rejection, Psychology; D012649:Self Concept; D014167:Transference, Psychology