THE STAGES OF HEALING, PART SIX: AUTONOMY VERSUS TERMINATION

How does the therapeutic relationship end?

“Termination” is the ominous term used to describe the end-phase of conventional therapies. In this phase of therapy, the patient is thought to go through the final throws of separation and individuation issues, played out in transference with the therapist. This is also supposed to be a time when the patient will temporarily regress into a final crisis, until finally arriving to a state of autonomy. A requirement here, in traditional thinking, is that the patient and therapist must sever all contact after a formerly agreed-upon last session. Thus, the absoluteness of the word, “termination.”
Yet, it seems obvious that if a patient needs to have such an absolute cut-off dictated to them by a dictating “authority figure”, the implication is that the patient is still quite prone to dependency... so, how “successful” could the therapy have been? (Ironically, termination is thought of as one of the most important phases of the treatment process and yet, it is the least talked or written about in the psychotherapy profession.)
There often is a crisis period that occurs in the later stages of a full-spectrum healing process as well, but it is not precipitated by the pending “termination” of the relationship with the therapist. This crisis occurs within the context of the therapy at its own natural time, without needing to have set an ending date to initiate it. It occurs naturally when the person is strong enough and no longer needs to be defended and armored against deep feelings. It is a deeply healing crisis. It can be a final grieving for the losses of one’s early life, or a final release of the terror caused by childhood traumas, or perhaps a final expression of anxiety as a patient’s sexual feelings emerge in full force.
The actual ending, in whatever form it takes, of the therapeutic relationship becomes kind of anti-climactic, then, more like a transition experienced with a celebratory sigh and embrace, not with a somber tone of severance. Because neither the patient nor the therapist are neurotically dependent on one another, the ending need not be compulsorily absolute. What actually ends at the “end” of a successful therapy is the continued making of transferences to the therapist – and for that matter, to any other people in the patient’s life. The patient acknowledges comfortably at this point that the therapist and he or she are “equals”, adults who are not in need of parental figures anymore. So, the therapeutic relationship, like every relationship, can end or transform gracefully, according to the nature and purpose of the connection between the two individuals.