ABSTRACT

This chapter considers some of the ways in which the therapist and the patient seek to manage the distress of loss. If a patient achieves enough self-confidence to discuss ending and tries to seek to negotiate it with the therapist, reactions vary. Sometimes a patient and therapist can join in a sort of cheerful collusion that there is an external reason for an ending. A difficult patient makes the ordinary therapist sometimes wish for the ending. Fears about ending or retiring are clearly evident in both therapists and their patients. The importance of this resort to omnipotence is clear to anyone who has to deal with the distress of patients whose ending of therapy has been painful and counterproductive. The relevance of the motivation becomes clear when one begins to interrogate the data over questions of therapist attitudes to enabling or accepting endings from their clients.