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The lack of a systematic follow-up of our cases several years after treatment is ended makes difficult an accurate assessment of the criteria for termination. We know something of the cases which come back for more analysis and the reasons for the incompleteness of the first therapy, but we do not usually know enough about those who do not come back, though we sometimes get favourable accounts of those whose analysis was terminated before we, at the time, thought advisable.
There is a second reason for hesitation in defining the criteria. The class of case now treated, speaking generally, is more of the character analysis type than the simpler hysteria and obsessional with which psycho-analytical work in the main began. Both our frontiers and our method of work are changing, and also our criteria.
In an analysis two parties have to be satisfied, the patient and the therapist. The patient is often satisfied too early with the results obtained in the procedure, while the therapist has his own and less subjective criteria. One of these can be given a sort of code name, ‘Irreversibility;’ i.e. the process of improvement in personality-integration and adaptability, which has been reached thus far, should be of such a degree and kind that, even without further analytical aid, there will be no reverse process or regression on the cessation of treatment—granted of course that no enormous stress is put upon the patient after treatment ends. The matter can be viewed in another way, viz. has the treatment removed the major obstacles to the action of the integrative processes which operate within every living organism, so that these integrative processes will in the end get the upper hand without further analytical aid?