ABSTRACT
Why should ending be such a problem for psychotherapists and their patients? 1 What is there about psychotherapy that makes some patients willing to spend their time and money to visit a therapist regularly, when to their friends and family there seems to be no obvious reason for doing so? Is psychotherapy unique in this respect? A little thought suggests it is not unique. The same phenomenon can be seen in emergency rooms and walk-in clinics. The staff soon come to recognize the “regulars”—patients who can be counted on to phone or visit at least weekly. Some of these patients try to legitimize their calls or visits by demanding that something specific be done for them, typically an extra sleeping pill or something for pain. Others are content to call and, after making some pro forma complaint, chat a bit and then hang up or leave. We do not usually think of these casual contacts as psychotherapy, but these patients use them in much the same way as some patients in psychotherapy who don’t seem to be getting anywhere.
