The problems of ending when the end is death
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The problems of ending when the end is death book
The ending of psychotherapy is sometimes referred to as a symbolic death but preparing for the ending with the knowledge that the patient will actually die alters this. At the end of psychotherapy, the transference may resolve but this too is different when the patient is dying. Psychoanalysts and psychotherapists have written about this particular form of ending and examples from the literature are cited. Stages of acceptance of a life-threatening illness are discussed. At the beginning of the third year of analysis the patient’s health deteriorated and it became imperative for him to talk his family. There was a strong pull for the analyst to relinquish the analytic stance and befriend the patient but this impulse was overcome by the greater awareness of the need to maintain the analysis to the end. The relentless progress of the disease led to great sadness. When emotion came to the fore a psychological steel shutter would prevent the patient from feeling too much. Talking about the end included confronting what he imagined would happen to his body – where he might be laid to rest.