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Beginnings and Endings: Time and Termination in Psychoanalysis by Danielle…
Beginnings and Endings: Time and Termination in Psychoanalysis by Danielle Knafo
Beginning to end
Time
the reality of time and limits are also forever present, even if unacknowledged.
Arlow (1986)
that psychoanalysis “functions in [an] intimate and consistent . . . involvement with time”
Green (2000)
“the real object of psychoanalysis is temporality”
Bass (2009)
“bringing something to a stop so that it extends no further”
Case Illustration: Woman in the Mist
Jhon
Because there were many endings in John’s life at once, I knew I needed to keep my eye on the ending we were approaching.
unconsciously preparing
dreams
John came to one of the final sessions with an awareness that terminating his análisis and leaving NYC involved grieving for the “woman in the mist,” his fantasy of the perfect woman, a fantasy he had never mentioned but one that reminded me of the woman in gauze from the first session.
“I don’t have to say goodbye to you. You’re coming with me. What I’m saying goodbye to is being here. But not to the structure that has been built through dialogue.”
new material often emerges in the final phase of treatment
It is one of the ways patients let us know there is more work to be done, that no analysis is complete.
we end an analysis but never really terminate it.
he longed for the elusive woman in the mist—the mother of his childhood whom he could never completely conquer.
clearly internalized the therapeutic skills—the self-analytic function— as well as me as his analyst and a significant person in his life.
first session
John’s treatment began with a drawing. A drawing by Mary, his current girlfriend. The drawing was of a woman wrapped in gauze. John said nonchalantly, that Mary claimed she felt unseen by him.
end
When we say to a patient, “time is up,” the ending is there in the room.
Whenever there is not enough time to fully analyze a dream, the ending is there in the room.
When there is a pause in the dialogue, the ending is there in the room.
When we inform the patient of our vacation schedule, the ending is there in the room.
interruptions and breaks endured
Self-consciousness of death
psychological treatment
Ending
denial
avoidance of termination
“I don’t want to talk about this”
Begining
we consider that we are, from the start, dealing with
termination issues
a linear paradigm—beginning, middle, and end—does not adequately represent the messiness or unique and idiosyncratic nature of the trajectories of individual analyses
Incomplete
Transcends the need for the analytic relationship
Insight
patient
treatment end prematurely and one-sidedly
wrath
wrath
afraid
therapist
Therapists may decide they cannot treat a
particular person or problem
Complete
A successful termination
brings with it a sense of having transcended the need for the relationship, but with the important caveat that the analytic process will continue.
The dynamic process
the therapeutic work
the internalization of the relationship
self-analysis
Begginnings foretell endings, and endings harken to beginnings
Beginnings and endings of analysis, like the game of chess, to have reatively few variatiosn (Freud, 1913)
“Analysis Terminable and
Interminable” (Freud, 1937)
“There is no ‘end of the line’ in analysis— only the final stopping place at which the analyst gets off" (Britton, 2010, p. 39).
Cooper (2010) notes that termination presents an opportunity to examine previously underappreciated aspects of the transference countertransference relationship.
The work of psychoanalysis involves the work of mourning and the understanding, sorting out, linking and separating of past, present, and future (Craig, 2002)
Time, loss and mourning are intrinsic parts of every analysis from beginning to end (Knafo, 2017)
beginning
Analysis
Involves a duel
capacity of the analysis to replace the analyst with self -analysis
the dinamic process, the terapeutic work, the internalization of the relationship, all live on past the ending
wishes, longings, defenses and relational systems
the ending was present in the beginning