Late Middle Phase/Termination

Fourth Year Adult Psychoanalytic Training (APT)
2023-24, 3rd Trimester — Fridays, 3:30-5:00pm
Randall Paulsen, MD
John De Mott, DO


Introduction

This seminar will explore the concepts of late mid-phase, termination, and the transitions inherent to those concepts. Mostly our emphasis will be on experience-near clinical material that should help illuminate psychoanalytic literature’s commentary on the process of analysts and analysands working their way through termination.

Termination, like most analytic concepts, is multifaceted. Grief and pain are healthy aspects of the process of ending and we will also consider the role of play attendant to ending. Moreover, we will consider termination as a transitional phase between the analysis and whatever comes “after.” And then we will examine the intrapsychic function of the analyst after termination.

Learning Objectives

  1. Identify analytic work in the “termination phase” as distinct from the opening and mid-phase
  2. Consider the developmental tasks relevant for analysand and analyst in the termination phase
  3. Discover the creative potential in the termination phase for the patient, analyst, and the analysis

March 8, 2024 — An Overview of Termination’s Place over the last 100 years

[21 pages]

Objective: Students will be able to discuss three basic concepts of termination: loss, mourning, and internalization of the analyst.

Salberg, J. (2012). Historical Overview in Good Enough Endings (pp. 3-23). Routledge Press.

Salberg, J. (2010). “Historical Overview” in Good Enough Endings: Breaks, Interruptions, and Terminations from Contemporary Relational Perspectives (J. Salberg, Ed.) New York: Routledge, pp3-23.

Optional Reading

Freud, S. (1937). Analysis Terminable and Interminable. Int. J. Psycho-Anal., 18:373-405.

March 15, 2024 — Mid-Phase and its Cultural Aspects

[30 pages]

Objective: The class will be able to consider the role of repetition in the mid-phase of a treatment and begin to think about repetition’s role in transitioning to a termination phase.

Freud, S. (1914). “Remembering, Repeating and Working-Through (Further Recommendations on the Technique of Psycho-Analysis II)” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913): The Case of Schreber, Papers on Technique and Other Works, pp145-156.

Holmes, D.E. (2016). Come Hither, American Psychoanalysis: Our Complex Multicultural America Needs What We Have to Offer. In Journal of the American Psychoanalytic Association, 64(3), pp. 569-586

March 22, 2024 — The role of termination in clinical work

[21 pages]

Objective: The class will be able to consider the significance of termination as a clinical process.

Dewald, P.A. (1982) The Clinical Importance of the Termination Phase. Psychoanalytic Inquiry, 2:441-461

March 29, 2024 — What kind of Endings Occur in Termination

[12 pages]

Objective: Students will be able to identify issues associated with termination such as separateness, or reworking of conflicts.

Loewald, H.W. (1988). Termination Analyzable and Unanalyzable. Psychoanal. St. Child, 43:155-166.

Optional Reading

Freud, S. (1937). Analysis Terminable and Interminable. Int. J. Psycho-Anal., 18:373-405.

April 5, 2024 — Termination as a Developmental Process

[17 pages]

*The mid-term class evaluation will be conducted during this session. Please use these questions to facilitate your discussion: Midterm Evaluation Questions

Objective: The class will consider termination as a developmental task necessary for the treatment and be able to describe the concept of “object removal.”

Katan, A. (1951) The Role of “Displacement” in Agoraphobia. International Journal of Psychoanalysis, 32:41-50

Knafo, D. (2018). Beginnings and endings: Time and termination in psychoanalysis. Psychoanalytic Psychology, 35(1), pp1-7

April 12, 2024 — Asymmetrical Aspects of Termination

[10 pages]

Objective:  Students will be able to identify how different kinds of endings affect the retained memory of the analytic work.

Reis, B. (2010), “Afterwardness and termination” in Good Enough Endings: Breaks, Interruptions, and Terminations from Contemporary Relational Perspectives, Jill Salberg, ed., pp213-222.

April 19, 2024 — The Uncertainty at the Heart of the Psychoanalytic Process

[16 pages]

Objective: Students will be able to describe the intrapsychic presence of the therapist for the patient post termination.

Bass, A. (2009). “It Ain’t Over Until it’s Over” Infinite Conversations, Imperfect Endings, and the Elusive Nature of Termination. Psychoanalytic Dialogues. 19:744-759.

Optional Reading

Freud, S. (1915) On Transience (S.E. XIV, Pages 303-307).

April 26, 2024 — Playfulness or Its Absence in the Termination Phase

[25 pages]

Objective: Students will be able to explain the concept of transitional space as it may apply to the work of termination.

Winnicott, D.W. (1971). Chapter 1: “Transitional Objects and Transitional Phenomena” in Playing and Reality. London: Tavistock Publications, pp1-25

May 3, 2024 — Post Analytic Contact

[34 pages]

Objective: Students will be able to discuss the current data on post-analytic contact between patient and analyst.

Kantrowitz, J. (2017), Ch4, “The effect of post-analytic contact” in Myths of Termination, pp80-105

Gabbard, G.O. (2021) The “dragons of primeval days”: Termination and the persistence of the infantile, IJP, 102:3, 595-602

May 10, 2024 — Psychological Events that Occur after Termination

[20 pages]

Objective: Students will be able to discuss Orgel’s ideas about attachment, interpretation, loss, mourning, and degrees of internalization.

Orgel, S. (2000). Letting Go: Some Thoughts about Termination. JAPA. 48:719-738

May 17, 2024 — The Ideal vs. The Real at Termination

[20 pages]

Objective: Students will be able to identify the differences between theory-based ideals of termination and experienced-based realities.

Gabbard, G. (2009). What is a “Good Enough” Termination? JAPA, 57:575-594.