Termination of psychoanalysis or psychotherapy is centrally important both to the process of treatment and to the patient's experience of treatment. It is surprising, then, that there has heretofore been no comprehensive study of the subject. This book begins to bridge the gap in this area. It is the first volume devoted entirely to issues surrounding the ending of treatment in analytic and therapeutic work with children and adolescents. Organized into separate clinical and theoretical sections, framed by a preface and sectional introductions, and covering a wide range of psychopathology, this book explores the different ways in which children and adolescents grapple with the experience of separation at the conclusion of treatment. Of special note is the contributors' recognition that the parents of children ending treatment face their own termination experience in relinquishing the support of their child's therapist. The presentations are enriched, as well, by frank discussions of countertransference as it enters into the termination phase of treatment.
"Anita Schmukler has made a significant contribution not only to child and adolescent psychoanalysis, but to our understanding of how children and adolescents engage in saying goodbye. This process is viewed though a series of case presentations that enable each reader to know the clinical data on which the theoretical and technical aspects of termination are considered. I recommend this casebook to all child and adolescent experts because 'saying goodbye' is such a vital experience in growing up."
- Albert J. Solnit, M.D., Yale Child Study Center
"In this much-needed and admirable collection of papers, termination of psychoanalytic treatment is addressed from many different perspectives. Dynamically linking termination to separation processes, reactions to loss, and the capacity to mourn, the book delineates, from the fresh perspective of termination issues, the normal and pathological conflicts of childhood and adolescence. The clinical papers and the theoretical expositions explore these complex issues with impressive scholarship. Saying Goodbye should be required reading for every child analyst and will greatly benefit adult analysts as well."
Peter B. Neubauer, M.D., Department of Psychiatry, New York University
"Saying Goodbye is much more than a casebook of termination, for in addition to rich and vivid clinical descriptions of the termination experiences of 10 child and adolescent patients, it contains comprehensive and comprehensible discussions of the theoretical issues involved in termination. These issues are basic and practical: criteria for termination and recognition of the patient's entry into this phase of analysis; the analytic process and the analyst's interventions during this phase; the analyst's emotional reactions to both patients and their parents; and the role of the parents in termination. Most importantly, Schmukler and her contributors deal extensively with children's and adolescents' many reactions to ending treatment: their creative adaptations, their mourning and defenses against grief and anxiety; and their reworking of major conflicts as they prepare to lose the therapist. The book provides many helpful technical suggestions for helping children to engage productively in termination. It is essential reading for analysts and therapists who work with chidren and adolescents and will enrich the work of those who treat adults."
- Jules Glenn, M.D., Former President, Association for Child Psychoanalysis
"The volume accomplishes its set goal: to provide clinical examples of the termination process in children of different developmental levels and varying psychopathology and to develop a set of concepts and principles to inform that process."
- Moisy Shopper, M.D., International Journal of Psychoanalysis
Table of Contents
I. Clinical Contributions 1. Termination of Psychoanalysis with an Early Latency Girl, Sugarman 2. The Reorganization of a Cross-Gender Symptom, Haber 3. Termination in a Midlatency Boy, Gonzalez 4. Echoes of a Family Secret, Brinich 5. Concealment in Early Adolescence, Hoffman 6. An Early Adolescent Girl Ends Her Analysis, Plaschkes 7. Developmental Issues in the Termination of Analysis in Adolescence, Ubbels 8. Singing Harmony: Termination in an Adolescent Analysis, Yanof 9. Ambiguity in Termination, Kay 10. Termination in the Analysis of an Adolescent Girl, Frenkel II. Theoretical Papers 11. The Transference Neurosis in Child Analysis, Chused 12. Vicissitudes of Termination: Transferences and Countertransferences, Weiss 13. Deciding on Termination: The Relevance of Child and Adolescent Analytic Experience to Work with Adults, Novick, Novick 14. Issues of Termination in the Psychoanalysis of the Severly Disturbed Adolescent, Burgner 15. Termination in Child Psychoanalysis: Criteria from Within the Sessions, Kernberg 16. Termination in Psychotherapy with Children and Adolescents, Gillman
About the Editor
Anita G. Schmukler, D.O., is Faculty and Supervising Analyst, Child and Adolescent Analysis, Philadelphia Association for Psychoanalysis, and Clinical Assistant Professor of Psychiatry, University of Pennsylvania.