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Freud states, in “Analysis Terminable and Interminable” (Freud 1937), that the end of an analysis (which is, in his opinion, an “ambiguous phrase”) requires two conditions in order to be fulfilled. Firstly, that the patient shall no longer be suffering from his symptoms, anxieties and inhibitions, and, secondly, that the changes produced prevent their repetition. If these conditions have not been achieved due to external difficulties, Freud suggests talking of an “incomplete analysis” (1937, 219). However, clinical experience also showed that other outcomes are possible. Patients can get worse during the analysis, for example, in the case of a therapeutic negative reaction. The progress of the analytic process can stop in situations of stalemate or impasse. Each analysis has, in fact, its own way of termination, as it has also its own process, history and protagonists.
From the very beginning of his work, Freud was aware that adverse events can occur. In 1900 he wrote to Fliess:
I am beginning to understand that the apparently interminable nature of the treatment is something determined by law and is dependent on the transference … such a prolongation is a compromise between being ill and being well which patients themselves desire and to which for that reason the physician should not consent. (Letter 133, quoted from Strachey, Editor’s Note to “Analysis Terminable and Interminable” [Freud 1937, 256])
When I read Mr K’s case history, I remember Freud’s description of the “compromise between being well and being bad” that compelled the analyst to consider the end of the analysis. In a session two weeks before termination, we learn that Karl’s analyst communicated to his patient his decision to end Karl’s 10-year long analysis: “While Karl argued that he still didn’t feel competent, I told him I felt that continuing the analysis strengthened his position that he remained the still neglected child who had grown up to be incompetent.” The analyst adds: “I had said that it