Introduction

The articles that follow are rich and diverse. All of the authors are senior psychoanalytic psychiatrists who have had decades of practice experience, arching over changing, as well as conflicting trends, in theory, in practice patterns, and in the economic and cultural support for psychotherapy. All are members of a psychoanalytic faculty, in an institute that accepts that there are multiple useful frameworks, for both theory and constructive, responsible treatment.

Standardization of treatment, beloved by insurance companies, is the bête noire of the highly individualized work done in our consulting rooms by psychodynamic psychiatrists; yet there does need to be some gravitational pull that organizes our thinking about the commonalities of our work, without attempting “toggle switch”-type answers to complex questions. Patients who do not terminate (“non-terminating patients” being a useful nonjudgmental term) are a noteworthy component of the practices of many, if not most of us. This group of articles addresses multiple considerations about our work with patients who do not leave.

Each author explores the topic from his or her own current, evolved stance. Glucksman and Olarte both write of highly-attuned, ongoing treatment relationships of many years in which transferential and countertransferential elements are explored with admirable perceptiveness and openness; Schwartz, in a bravely autobiographical article informed by years of training and experience as a clinician, opens up his own analytic