“Progression,” an Alternative Conception to “Termination” to Denote the Ending of Successful Analytic Treatment

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Abstract

One psychoanalytic justification for the practice of not recommending posttermination patient-analyst contact to former patients is the assumption that such posttermination contact interferes with the patient’s mourning response to the loss of the analyst. We respond to that assumption by describing the empirical studies that have shown that posttermination patient-analyst contacts did not interfere with the patient’s mourning response. A previously published case study of posttermination patient-analyst contact is presented that seemed beneficial to both patient and analyst. However, empirical surveys indicate that very few analysts ask to see the terminating patient after a specific time after termination. The concept of termination has long been widely criticized as being unsatisfactory, but no alternative conception of the end of analytic treatment has been offered. This article proposes a new conception, that successful completion of analytic treatment be termed, “progression,” not termination. A patient who has completed treatment may have become independent, self-aware, and engaged in a more gratifying life, while also valuing subsequent periodic contacts with the former analyst. Such contacts in turn indicate the analyst’s continued interest, caring and concern, and may revitalize the patient’s internalizations developed during treatment, while also providing an opportunity to reduce exaggerated idealizations of the analyst. These contacts provide the analyst with information about the patient’s postanalytic course and development, making possible a revision of the analyst’s evaluation of the effectiveness of prior analytic treatment, and, in addition, enabling the analyst to revise unresolved countertransferences to the patient.

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