Ending, Not Quite Ending, and Not Ending At All

Abstract

I consider the place of termination in contemporary psychoanalytic practice. A more flexible approach to therapeutic endings represents one dimension of a broader paradigm shift away from rule-boundedness and toward clinical flexibility. In any event, final, less-than-final, and absent goodbyes have always been part of psychoanalytic reality despite the power of our termination ideal. I first describe the broader move toward flexibility within the field and then address its complex implications for psychoanalytic endings. In that context, I explore the varied ways in which we don't always end treatment relationships. The implications of not entirely ending a treatment are also addressed.

Keywords: COVID; Post-treatment friendship; Termination; analytic flexibility; analytic ideal; developmental tilt.