Discussion of Dr. Fayek's Paper

In the discussion section of this fascinating case presentation, Dr. Fayek focuses on issues of termination and makes a number of important points, many made before but nevertheless worth repeating. He states that termination is not when but what. This relates to the general issue of the goals of analysis, a topic which has exercised clinicians and outcome researchers from the beginning (J. Novick, 1982). I am pleased that he has arrived at a position similar to one we have suggested regarding the end phase task and resistance for both patient and analyst. We have said that a major task facing patient and analyst during the termination phase is that of setting aside omnipotent beliefs (J. Novick, 1992; K. K. Novick & J. Novick, 1998; J. Novick & K. K. Novick, 2000). The patient's initial “unilateral termination plan” (Novick, 1976) stems from an omnipotent belief. It is a magical cure fantasy and Dr. Fayek demonstrates with rich clinical detail and argues persuasively that giving up this magical cure fantasy is the “What has to be achieved for termination to happen” (p. 29). However, termination is not only what, but also how. Dr. Fayek implies this when he asks who initiates termination. Important as this question is, it is subsumed by the larger issue of how the analyst conceptualizes this phase of treatment.

For the first fifty years of the Psychoanalytic Century termination as a phase of treatment was little discussed and in actual practice the end of analysis was treated in a rather cavalier manner. We can date the current interest in the topic to the symposium on termination held at the British Psychoanalytic Society and published in 1950. By