Termination2

TERMINATION OF TREATMENT GENERALLY implies a cure. The physically ill patient, for example, usually stays in medical treatment until he is declared physically well. However, since cure in the case of psychoanalysis usually is defined in vague, abstract and ideal terms, it seems more fruitful to think about termination in terms of the patient's capacity to deal with his problems, rather than in terms of a cure. Therapy should help the person become more tolerant of himself through his understanding of the underlying meaning of his former feelings of shame, disappointment, discomfort, and anxiety. Once we think of it in this way, once we accept that termination need not imply cure in the usual sense of the term, we can admit that the early fixations and resulting dynamics that were at work in the past have not been totally eliminated by analysis. They are still there, and in future situations of stress they may give lively evidence of their presence.

The important question for termination is: has the patient achieved a good enough understanding of these forces and of the defensive systems which were in the past unavailable to him and were the sources of his misery? Will he be able to deal with them on his own? Will he in future situations of stress revert to the old reaction patterns which brought him into therapy in the first place, or can he cope with them constructively?

I have stated this central question in terms of "understanding" and "coping, " but understanding and coping are, of course, nothing without the courage to face and to bear what had been unbearable, and to name what was repressed and covered by defensive structures. An analysis that does not help the patient to confront life, to choose, to decide, to commit himself, will not have accomplished its purpose. Seen in this light, termination is indicated as soon as the patient is ready to assume responsibility for his