Meeting of the Psychoanalytic Association of New York

March 21, 1977. PANEL DISCUSSION: TERMINATION IN CHILD AND ADULT ANALYSIS. Samuel Abrams, M.D., Joseph T. Coltrera, M.D., and Stephen K. Firestein, M.D

Dr. Samuel Abrams opened his presentation to the Panel with a clinical illustration concerning the termination phase of the analysis of an eleven-year-old boy. The patient was a worried, self-assaultive child, whose parents had been divorced when he was five. He had been exposed to the parents' bedroom quarreling to which he had reacted with violent, murderous impulses, subsequently disavowed and forgotten. In addition, his curiosity and fantasies about his parents' sexual relations had also been denied. After a date for termination had been set and accepted by the parents, an illuminating dream was presented and worked on by the child and his analyst with extremely productive and integrating results. Dr. Abrams cited this experience as a demonstration of the belief that the development and resolution of the transference neurosis was not a reliable sign of the arrival of the termination phase in child analysis. He suggested as a more useful and applicable approach the examination of four key questions. 1) Are the dynamic issues engaged, oedipal matters as well as pre-oedipal? 2) Have specific drive derivatives become manifest? 3) Has there been psychic restructuring, i.e., more appropriate defenses established? 4) Has the resolution of past conflicts found a more fortunate pathway? Without the satisfaction of these criteria, the analysis should be considered interrupted rather than terminated; indeed, it should be termed analytically oriented therapy rather than analysis. Dr. Abrams concluded his presentation with a discussion of technical procedures involved in the setting of a final date for termination.

Dr. Joseph Coltrera discussed termination in adult analysis, with its focus on the regressive pressures which facilitate the emergence of the transference neurosis. Noting the inappropriateness of the