Academic journal article International Journal of Psychoanalysis

Ethics in the Termination of Analysis1

Academic journal article International Journal of Psychoanalysis

Ethics in the Termination of Analysis1

Article excerpt

The author argues that the termination of analysis raises not only theoretical and technical issues but also problems of evaluation that are both moral (what is good or bad with regard to termination) and ethical (what is the best way of achieving the intended objective). Broadly speaking, he considers that the subject can be addressed from three different aspects: (a) a psychoanalysis of ethics; (b) an ethic of psychoanalytic treatment; (c) an area of intersection between psychoanalysis and ethics that has to do with mankind 's norms and values. The termination is particularly well suited to investigation of the intertwining of ethics with other aspects of psychic functioning. A specific description is given of the conflict between the 'limit' and 'completeness', the limit being connected with the analysis and the wish, while completeness is the possibility of experiencing the analysis and one's personal life as endowed with the 'sense of an end-point'. The conflict may be expressed in dramatic or tragic forms that can be productively explored through the Aristotelian concepts of peripeteia and recognition. The termination process offers material for establishing an ethics of the limit, highlighting the psychic role of moral judgement and the need to evaluate this role if a satisfactory termination is to be achieved.

Keywords: ethics, recognition, reversal, termination

Introduction

The termination of an analysis, for analysand and analyst alike, is a decidedly problematic experience that can be visualized as a wave of psychic activation, which can be either ridden - not for long and always with the risk of falling - or avoided owing to the terror to which it gives rise. One's attitude to it may be one of infinite postponement, or else one may yield to a (sometimes counter-phobic) impulse to 'plunge' into the open sea without waiting for the wave to materialize and assume its proper configuration. According to Balint (1968, p. 167), the analyst's task is precisely to carry the patient 'like water carries the swimmer or the earth carries the walker'. The wave image is intended to convey the dynamic nature of the concluding phase of the analytic process. This dynamism is not confined to the clinical level, but also pervades that of theory, in terms of a comparison of the various conceptions of the meaning of the termination, the means and ends that characterize it, and the criteria for its conceptual definition and clinical identification.

The termination constitutes the clinical moment when the question of the nature and significance of the word 'treatment' in psychoanalysis arises and defines the relevant conceptual sphere. The 'semantic cloud' (Ferraro and Garella, 2000) surrounding the terms 'treatment', 'illness', and 'cure' can readily become a thick fog, with consequent problems of getting one's bearings on the theoretical, clinical and ethical levels. This situation was neatly summed up by Pontalis (1978) as follows: recovery is an untreatable idea and 'C'est quand on ne peut pas guérir qu'il faut guérir' [It is when it is not possible to cure that curing is necessary] (Pontalis, 1978, p. 10). After all, the appearance of a prospect of termination implies that both analyst and analysand must, individually and as a couple, confront the significance, limits and defences connected with their conscious and unconscious expectations of the treatment, distributed over a number of levels and within a space of ends and expectations criss-crossed by many different trajectories, not all of which can be negotiated.

The interdependence of the termination, the general theory of the analytic process, and the metapsychological subset of choice (first topography, second topography, object relations, etc.) has already been explored (Ferraro and Garella, 2001), and will be addressed again here only in order to emphasize the fact that it is normative on the conscious level, so that it requires ethical behaviour, whereas at the same time it is (or can be) compulsive on that of the unconscious, in so far as unconscious expectations (wishes, as well as superego demands and ideal pressures) press for satisfaction regardless of the exigencies of reality. …

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