Endings and Beginnings, Second Edition : On terminating psychotherapy and psychoanalysis book cover
2nd Edition

Endings and Beginnings, Second Edition
On terminating psychotherapy and psychoanalysis

ISBN 9780415814072
Published October 1, 2013 by Routledge
272 Pages 5 B/W Illustrations

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Book Description

In this second edition of Endings & Beginnings (Routledge, 2006), Herbert J. Schlesinger explores endings and beginnings within psychoanalysis and psychoanalytic therapy; both the obvious main endings and beginnings of any course in treatment, and the many little endings and beginnings that permeate analysis. The second edition contains new chapters including one on transference and counter-transference as sources of information about the process of therapy and as sources of difficulty in ending. It deals especially with the impact of prospective ending on the therapist, which if not understood and well handled, might interfere with working through and impede termination, if not ending itself. Another new chapter deals with the difficulties in terminating with especially narcissistic patients.

One of the main criticisms against psychoanalysis and the psychotherapies derived from it is that it lacks criteria for when the patient has had enough. Herbert J. Schlesinger shows how we may view the process as a series of episodes each with an ending and possibly with a new beginning. He presents the way patients signal, even before they are aware of it, that ending is "in the air," and how it organizes how they experience the therapy. If alerted, the therapist can make use of these signals to locate self and patient in the process. So informed, the therapist is better able to discern when the therapy should end and help the patient work through the issues of separation and loss to terminate the treatment constructively.

All patients tend to end psychotherapy in the way they end all other relationships. In several chapters on the problems related to severe regression, therapists can learn how to help vulnerable patients, for whom attachment is problematic, deal with separation non-traumatically.

In Endings & Beginnings 2nd Edition, the theory of the continuous experience of ending and beginning and the array of landmarks that parse the clinical process are distinct advances to the technique of psychoanalysis and the psychotherapies derived from it. Schlesinger offers many clinical examples of ending and beginning with their technical problems and solutions. This contribution to the technique of ending and beginning psychotherapy electively will be useful to practicing psychotherapists and psychoanalysts, and to undergraduate and post-graduate students in clinical psychology, psychiatry and social work.

Table of Contents

Preface. A Little History and Some Definitions. Patterns of Ending Psychotherapy. How to Tell When Treatment May End. Beginning from the Vantage Point of Ending. Ending for "Beginners". Ending and Termination in the Treatment of Vulnerable Patients. Some Problems of Ending and Termination, Impasse or Stalemate. Countertransference Problems at the Ending of Treatment. Are there Persons We Should not Take Into Psychoanalysis? To Convert or not to Convert. Ending, Termination, and the Life Course of the Analyst. Mourning in the Analytic Situation: An Aspect of Termination, The Ubiquity of Mourning. Is there Life After Termination?

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"Endings & Beginnings, second edition is a small miracle; there is nothing quite like it. Schlesinger’s genius is to see that focusing on ‘endings’ in psychodynamic treatment is the way to parse, track, and manage all of treatment from first to last, as well as the way to individualize therapy, the way to keep the mission in focus, the way to define psychoanalysis and psychotherapy in operational terms, and, of course, the way to know when to stop. It is a hands-on book where practitioners at all levels of experience will find virtual vignettes of every patient they have encountered, sketched with extraordinary sympathy. Schlesinger gives us what we all want these days: a way to think realistically, helpfully, and planfully about the full range of patients without getting lost in traditional shibboleths or formal rituals, and without replacing our clinical mission with sheer improvisation and helpless submission to circumstance. The reader will be immediately helped in his work by any single page chosen at random, I can think of no one book that will save more therapists and more patients from wandering in the wilderness."Lawrence Friedman, M.D., Clinical Professor of Psychiatry, Weill-Cornell Medical College; and Faculty, New York University Psychoanalytic Institute

"The most accessible yet most sophisticated guide to the ending of psychoanalysis and psychoanalytic psychotherapy that also says an enormous amount about the beginning and the middle. It is filled to the brim with clinical wisdom as relevant to old hands as to neophytes." - Peter Fonagy, Freud Memorial Professor of Psychoanalysis, University College London