ABSTRACT
This chapter focuses on the ends of treatments and the ends of lives. Contemporary relational psychodynamic conceptualizations of mourning are discussed. Key aspects of this theory which are important in the psychotherapy of mourning older adults are that the tie to the one lost is not de-cathected but instead transformed and that the self, changed by the loss, must be restored. The psychotherapist assists in mourning by helping the patient bear emotional pain, by reducing negative self-judgment about the extent of pain, and by fostering the revision of the self-narrative. Psychotherapists’ mourning and the difficulties that complicate their mourning are then explored. In working with older adults, the most desirable end of a treatment, the mutually planned termination, is not always possible. Endings of treatments due to the deaths of patients and their effect on the therapist are discussed. The complications and uncertainties about whether, when or how to end when physical or cognitive changes make psychotherapy more difficult are also discussed. The chapter closes with a case illustration.
