On the “Unexpected” Termination of Psychoanalytic Therapy

What happens when the termination of psychoanalysis or psychoanalytic psychotherapy is “unexpected” by either the patient or the therapist? As my use of quotation marks suggests, there is a degree of doubt with regard to what can objectively be described as “unexpected,” for in some cases there may be a building up toward termination without the parties involved being wholly aware of it. Nevertheless, abrupt endings probably occur more often than is generally acknowledged. Whereas the sudden ending of psychotherapy with children and adolescents has been subjected to frequent examination, the literature on this disturbing development in the treatment of adults is remarkably scanty. The reasons for this are not altogether obvious or clear.

The therapist's decision to move to a new location is one common cause of unexpected termination. Dewald (1966) describes the reactions of four patients in psychoanalysis when he elected to settle in a different city. He concludes that “forced termination,” once a transference neurosis has been established, involves a number of reactions similar to those in termination of any analytic treatment. He mentions some specific elements affecting both patient and analyst and advocates adequate working through, thus