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The Termination Stage of Therapy

Time To Say Goodbye“Promise me you’ll never forget me because if I thought you would, I’d never leave.”  — A.A. Milne

The need to move forward is an unwavering attribute in the grand scheme of human evolution and expansion. This natural directive requires a letting go of what was so as to venture forth in pursuit of subsequent relationships and experiences.

These endings, which coincide with onward momentum, can take on diverse meaning depending on circumstance and perspective. Literal or psychological deaths and losses can inspire deep grief, anxiety, a sense of completion, feelings of liberation or a developmentally significant rite of passage.

Similarly, this natural occurrence in the cycle of life outside the therapeutic milieu is also intrinsic to the process of psychotherapy.

The conclusion of the therapeutic process brings about the inevitability of separation and loss. Goals may have been reached. The client or the therapist might be moving to a new location. Or perhaps the client is bolting from frightening memories or feelings.

It could be as basic as a ‘bad fit’ or logistical issues around money and time. Questionable ethics may even come into play. The reasons are manifold, but what this article will delve into is the mutually agreed upon consummation of long-term dynamic psychotherapy and the process of termination.

A Complex Stage

Termination is a complex stage embodying reflective nostalgic dialogue and a poignant honoring of the profound interpersonal bond between therapist and client. The nature of the therapeutic alliance, the complexity of the work, in conjunction with the client and therapist’s respective histories largely determines the composition and timbre of the termination process.

Ideally it is a reparative process that could serve as a catalyst for invaluable growth.

As the emotional bond between client and therapist deepens, critical relational milestones may ensue.  For instance, the therapist’s steadfast and principled emotional investment in the client can help ameliorate poor object constancy.

Object constancy is the sustaining experience of others as predictable and available even when they are not immediately present.

For those who have avoidant attachment styles, the previously denied affective aspects of separation may become more accessible for processing.

Those with ambivalent attachment may feel ready to reclaim autonomy, having assimilated the therapeutic bond (Perls) as a good object.

Those with disorganized attachment templates may have constructed a cohesive narrative of their relational trauma and be able to adequately self-sooth and emotionally regulate, so as to safely navigate the vicissitudes of the termination process.

Relational Milestones

These relational milestones and core wounds are salient indicators of the termination trajectory and are instrumental in determining the duration and frame of the termination process. Ergo, during the termination phase, the integrity of the therapeutic bond may be most tested as past losses, unresolved grief and regressive impulses resurface.

Although the cathected secure base of the therapeutic bond (Bowlby) has provided the empathic attunement and humanity to subdue overwhelming fear, helplessness, disillusionment and aloneness, as with many of life’s endings feelings of sadness, anger, grief, rejection and/or abandonment may be aroused, particularly for those with histories of relational trauma.

Significantly, leaving treatment crystallizes the disposition of transference / counter-transference dynamics. The transference relationship can span an ample spectrum of affectively charged projections and judgments that may encompass idealization, love, envy, erotic fantasies, and hateful aggressive feelings.

Utilizing the transference and counter-transference phenomena to tease out and understand the projections, emotions, and symptoms ignited by separation, so as to understand how the unconscious and relational traumas shape the way in which loss and separation is perceived and handled, is fundamental to the termination process.

Naturally In facilitating, the therapist must grasp her own attachment style and relational predilections. Most essential, is that the therapist comprehend her emotional entanglement with the client and her inner experience, needs and wishes.  The convergence of the mental representations of the client’s transference and the therapist’s counter-transference is complex fertile ground for exploration, which can assist the client with thoughtfully identifying and managing the expectations and projections she brings to new relationships.

The closure of a therapeutic relationship entails an in-depth and emotionally profound analysis of attachment in all its multi-faceted dimensions.

It is an opportunity to assist the client with owning his accomplishments, share mutual gratitude, and revise maladaptive relational patterns. Optimally, it is a unique and rare summation of the inherent power of the therapist-client bond.

The therapeutic relationship, which serves as a template for healthy love, in a life replete with ruptured bonds, betrayal, deficits with object constancy and negative endings, is indeed an enduring reparative gift for both client and therapist.

 

 

The Termination Stage of Therapy

Rev Sheri Heller, LCSW

Rev. Sheri Heller, LCSW, is a seasoned NYC psychotherapist with 25+ years experience in the addiction and mental health fields. Sheri is also an interfaith minister and playwright, and the founder of The Sistah Tribe - Phoenix Project, a therapeutic theater event for at-risk women and girls in the public sector of NYC. For more information, visit www.sheritherapist.com

 

APA Reference
Heller, R. (2016). The Termination Stage of Therapy. Psych Central. Retrieved on December 12, 2018, from https://pro.psychcentral.com/the-termination-stage-of-therapy/

 

Scientifically Reviewed
Last updated: 6 May 2016
Last reviewed: By John M. Grohol, Psy.D. on 6 May 2016
Published on PsychCentral.com. All rights reserved.