Many of our clinic staff and trainees will be making decisions about ending treatments. For some it will be a first experience with “termination” – I prefer “parting.” Now is a good time to consider how the Corona situation impacts upon this process.
When do we conclude a treatment? When everything is all wrapped up? As Freud gave thought to this issue late in his life, and actually after he had stopped doing treatments himself, he noted that one never reaches a “final goal.” Rather, our treatments are a means, not an ends. A means to what ends? To life, more healthy psychological life. And what is more healthy? Well, our clients have engaged with us in a process that includes mentalizing, analyzing, relating, putting into words that makes their emotional challenges, past present and future, more manageable for them. How more manageable? The procedures we have practiced with them have now become part of how they themselves live. So then the “treatment” continues, but without the therapist? Right.
Because LIFE continues without the therapist. We have moved something along together that now continues to move without us. But then, is the therapist erased, used, discarded?
Yes and no.Yes, in the sense that we do not want our clients to become addicted to us. We are not a permanent part of their LIFE, rather a temporary adjunct for acquiring and practicing approaches to life and relationships that will hopefully continue without us.
But NO, in the sense that we have engaged in a relationship that includes who we are, our presence. The co-creations have had two creators in the room. The WAY we have talked, laughed, despaired and hoped with our clients leaves indelible fingerprints, personal marks, on their lives – and on ours. But these marks now turn towards the real, that is, permanent relationships in their lives, and our influence merges into their personality.
So parting is not fun. It includes a sadness of loss, together with the pain of the inevitable breaking up of the images of those we lose. For some clients managing loss will become the most important part of the therapy, whose time comes only at the end.
When we talk of parting, we often recall together with clients moments in the treatment relationship that were particularly meaningful. We tell stories, we do not explain. As you know, people recall stories, not explanations. And we now can become more “real” and share with clients what this treatment has meant to us – and that it has had meaning for us.
And some of our story-telling will be Tales of Corona. We will look back on how the fears and the lockdown impacted upon our lives and upon our therapeutic relationship. We will zoom in and out of remote contact, interruptions, different experiences. We will be winding up a “Corona treatment,” for better or for worse.Paradoxically, the goal of ending treatment is to preserve “treatability;” we want to have clients leave us with the hope of being able to engage in treatment should they need it in the future. That means that we want to take upon ourselves – and perhaps Corona – the limitations of the treatment we are concluding. As we close the door on this chapter, we want to leave our clients with another door open to possible use of therapy in the future.