Ending Analysis: Comparative views1

How does one conceptualize the ending of an analytic process? The moderator of this panel, Nancy Kulish, introduced this discussion by comparing the panel's task to the position of artists stepping back from the immediacy of their paintings in order to see their work from different perspectives. There is a timeless quality to an analysis, yet with a backdrop that it will end at some point — but at what point? Are there specific criteria that help in determining when to end treatment, and how does this affect technique? In order to explore these issues, Antonio Perez-Sanchez summarized an eight-year treatment, with particular emphasis on how ending the analysis was decided.

The patient was a man in his mid-30s who presented with intense anxiety, loneliness, somatic symptoms, and uncertainty about his sexual identity. While successful occupationally, he felt like an ‘imposter’. The patient settled into what appeared to be a good working analytic relationship, but Perez-Sanchez thought he was too compliant and suspected a hidden attitude of devaluation of the analysis. Perez-Sanchez presented a dream which he interpreted that illustrated this ‘secret perverse relationship with the analyst’ in which the patient was submitting to the analytic method, but inside himself was mistreating the analyst. As the sadomasochism was uncovered and worked with, the patient made progress, as evidenced by more realistic attitudes toward work, greater closeness with the analyst, and less tortured, sadomasochistic relationships in his life.

The patient brought up ending his analysis several times in the two years before a termination date was set — times Perez-Sanchez termed as a ‘flight forward’. The patient considered ending again in his sixth year. Leaving analysis frightened him and he felt some disappointment that the analysis had not provided what he initially expected — the capacity to create a family with children — but it had allowed him to become freer and more comfortable. The a