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David is thirteen and on the threshold of puberty. He is very small for his age and gives no external sign of the move towards adolescence. Dressed in his school uniform—long trousers, striped school tie and emblazoned jacket—he bears himself with composure. He looks, perhaps, more like a slight eleven-year-old, who has only recently begun secondary school and is quietly proud of his new status. His square hornrimmed glasses and narrow sensitive face combine to give him a scholarly air.
David has been in treatment for five years. The treatment material has borne out the initial diagnosis suggested by Miss Freud, that he suffered from a severe developmental disturbance resulting from his many physical problems, his parents’ inability to compensate for them, and the traumatic loss of an au pair when he was two. An earlier paper1 detailing the first two years of David's analysis shows how these factors contributed to his difficulties at all developmental levels. This present paper shows how they made for special difficulties when it came to terminating the analysis.
The regulation of this ending has been left to David. It has been a gradual, long-drawn-out process which is not yet quite complete. David is still coming once a fortnight and will not be hurried. Six months ago, a remark of mine which he misconstrued as putting pressure on him brought the response which I have chosen as the title of this paper: ‘I'll stop when I'm ready and able’.
This paper gives a brief account of David's life and treatment up to the termination phase.
Born two months prematurely, kept in intensive care for several weeks and then returned to hospital at three months for an operation on bilateral inguinal herniae, David was a difficult