Alternative Endings
Margaret Atwood, famous for "The Handmaids Tale," decades ago wrote a short essay called "Happy Endings". It was about a couple: John and Mary
This short writing is fascinating. There is not just one ending, but several alternatives. And you get to chose the one you most fancy. Nevertheless when it comes to endings, writes Atwood,
You'll have to face it, the endings are the same however you slice it. Don't be deluded by any other endings, they're all fake, either deliberately fake, with malicious intent to deceive, or just motivated by excessive optimism if not by downright sentimentality.
The only authentic ending is the one provided here:
John and Mary die. John and Mary die. John and Mary die.
So much for endings. Beginnings are always more fun. True connoisseurs, however, are known to favor the stretch in between, since it's the hardest to do anything with.
Probably there are as many endings as there have been analysands. But why should all analyses end alike anyway? It seems to me that demands to codify, phase, "stage" or provide some checklist, do's and don'ts, or indicators for an ending of analysis arise, more often than not from pressures external to the analysis. True, some analysands want to know at their very first session when an ending will take place and what they will have achieved when it arrives. In my experience many such people do not stay around for very long! But if they do, the entire analysis might well be dominated by this worrying set of questions. At the end of their analysis, the subject might exclaim "what happened to my analysis" and start another.
Contrariwise, other therapies impose a time-limit at the very beginning. This is customary in Cognitive Analytic Therapy for example, which justifies the procedure on therapeutic grounds, such as claiming it to be an incentive towards change and moving on. In other words it methodologically discourages patient dependency and promises health economists a quick, cost-effective turnover. Freud did this at least once in his career and Ferenczi regularly for a while. Such procedures are commonplace in regimes where supply, cost, and demand are urgent preoccupations -like national health schemes, employer assistance programmes, private medical insurance, consumer counselling, or life event coaching. All this is quaintly enshrined in the odd word "modality", which for me is primarily a musical concept, second a logical term, and only in third place is it something to do with trendy fashion.
In an online article Owen Hewitson notes another irony about endings:
Leaving aside the question of its ends, many people who consult a psychoanalyst – perhaps any form of therapist – do not stick around long enough to even begin. Indeed, the majority of those who come to a psychoanalyst for an initial consultation never come back.
Words like end, ends, ending are richly complex signifiers. They can mean goals, purposes, achievement, completion -as well as the act of finishing. Older analysts, influenced by medicine, preferred the word termination. But in modern times this word is associated with procedures like "termination of pregnancy" or "termination of life" which have their own ethical imperatives and moral baggage.
Frequently discussions about "endings" are therefore related to clock-time, rates, and money. Perhaps inevitable, but in my own experience of psychoanalysis "time" is one of those everyday coordinates that became transformed, enriched, more complex. Pearl King, an analyst in the British independent stream, shared this perspective too.
The analytic relationship and what happens within it, is both within Time and beyond Time. It is also out of Time. I suppose that we are dealing with a paradox. The Psychoanalytic relationship takes place in time, and keeping time, with its intimate link with space, and therefore with place, (which links with togetherness and with separation) has to be acknowledged in the present of the session. Yet according to Freud we have to be able to work and to see our patients within the context of their whole life span. Pearl King 1996
The easiest statement about ending an analysis is that it occurs when analyst and analysand stop meeting. This is a factual and descriptive statement. But it is rather empty and says little about hows, whys, wherefores, outcomes. These meta-questions refer to those "central bits" that Atwood claims are the most challenging -and absorbing- task facing any novelist. The descriptive statement is also a little simplistic. I remember a former NHS user turning up at my private practice without any booking. He was desperate to talk, despite having finishing over three years previously. During the past three years a first-class degree was obtained in a technical pursuit, which had incredible employment prospects. The individual concerned attended just twice on that visit. For decades now I have neither seen nor heard anything more from the individual concerned. Which was session was the end? What was his end or ends?
During several decades of involvement in the psychoanalytic scene, I have known several analysts who opted for more analysis after a formal ending or even after being processed by the sometimes gruelling Lacanian pass system. There were others, practitioners of psychoanalysis for a very long time, who seemed to have endings that are "ongoing", "interminable" "indefinitely delayed", "hypothecated", or "resumable". Such instances of apparent endings followed by resumptions, come from my personal observations during several decades of involvement in this scene. Manifestly they contradict another official criterion for satisfactory psychoanalytic endings which was championed during the fifties and sixties of the last century -namely irreversibility. Nevertheless, even professionals appear to need shoring up from time to time -if not permanently.
But why should an analysis or psychotherapy end at all ...especially if the participant wants more? Such an individual may be a valuable asset to any therapist as well as simultaneously reducing costs upon scarce state or social services. Less facetiously, but equally pertinent, is the issue of why a professional operating with talking therapies should even introduce topics about endings if a fee paying client wishes not to discuss them?
As previously noted, it is regularly the demand for short-term treatments that forces professionals to discuss endings or set dates for an ending at the very first meeting. But in the private market presumably, one could continue listening indefinitely......... or until external events intervene in some irrevocable way such as disruptions to employment status, organic changes for better and worse, strikes, divorce, birth of a child, death of a relative and more. In my experience it is intervening and unforeseeable events such as these that, more often than not, become harbingers of a finishing.
To complete this section, I need to note one extremely pervasive trend influencing ends or endings: namely the commodification of training. In the article previously mentioned, Hewitson refers to two contemporary Lacanian trainings which claim prospective analysts need a minimum of four years in analysis. This particular commodification is due to a massive shift in psychoanalytic paradigms. Once it was medicine that provided the main professional paradigm for analysts. You will remember how Anna Freud, though never becoming a doctor, was made to attend medical school for a while by her father. Older colleagues of mine, still living, were encouraged to change degree courses from arts subjects to medicine in preparation for their future careers. During basic medical training, as well additional training in psychiatry, these people not only received an ongoing analysis, but a training analysis as well -if their candidature was accepted. In the United States it was once almost impossible to become an analyst without possessing a medical degree.
Now this four years requirement commended by some UK trainings fits unsurprisingly well into existing paradigms promoted by national psychotherapy councils. It also dovetails neatly into the academic training structures required for clinical psychology or counselling psychology registrations. One could almost say, like treatments, academic commodification has turned preparation into a "mode" of training geared towards particular marketable "skills". Presumably, after submitting to such minimalist regimes and paying their fees, a candidate feels entitled to call her/him/a self an analyst and licensed to operate in that mode. Maybe this is inevitable. Maybe psychoanalysis is always adapting itself into something that can always be sold! Maybe the most successful application of psychoanalysis is market advertising! But these repackaged profession is something I would not personally wish to buy..... or sell... or necessarily call its mass produced end-product "an analyst".
Finally there are genuine instances in which people are unable to bring their analyses to any ending during clock or digital time. In previous eras they were termed unanalysable, psychotic, disordered, or perverse. Most of these words may seem to be a little pejorative to contemporaries -being laden with moral suspicions directed towards anOther. If somebody does not complete an analysis in a way you approve of, the failure can always be accounted for by the abuse of pseudo-clinical names or disparaged in some other way. If it is about anything, psychoanalysis has to do with desires, hopes, and phantasies which are not fully consciousness or admitted or talked about by subjects. How is an analyst then supposed to know in advance about the whys and wherefores of analytical processes that have not yet occurred unless he or she has become a fortune-teller or clairvoyant?
Elasticity and Exhaustion
Bungee jumping at Victoria Falls public domain
His motives for experimentation with technique were varied. Chief amongst them was a drive to make psychoanalysis more clinically effective, briefer, and more affordable in an era where there were few national health schemes. Secondly there was his clinical attraction to patients who were incredibly complex and demanding. He proudly took referrals from analysts who could not handle their customers. Whereas most analysts confined themselves to mainstream neurotics -like Freud's hysterics and obsessives- Sandor Ferenzci's list included significant numbers of people with psychosis, personality disorders, perverse traits, and criminals. To support the analyses of such people, analysis needed to be stretched in another sense. Not only the traditional patient type needed to be stretched, but the content and style of the analysis, as well as its atmosphere, needed to be stretched too. Balint defused the elasticity debate a little, arguing that a large element of what Ferenczi called elasticity was clinical "tact" and knowhow gleaned from listening hundreds of demanding analysands. But that was a little misleading.
Analysis of complex clients, he argued, sometimes demanded full reconsideration of pre-Oedipal events. So he and his colleagues welcomed the occurrence of "regressions" during clinical sessions.This tradition was continued in the United Kingdom by emigre analyst Michael Balint, for whom it was a viable alternative to Klein's work with primitive states (but without utilising her regime of heavy interpretation). When dealing with such clinical phenomena members of the Hungarian School contested that the atmosphere of the analytical setting needed drastic alteration: ..... so that contemporary analysts should create a more welcoming relaxed environment than they were wont. For more profound observations about this, it is best to read Ferenzci's article about unwanted children and their death drives.
In this context it should be recalled that many of Freud's published case histories were of limited outcome, if not complete failures. But he tried to learn from them. It is now obvious that his actual clinical practices often veered dramatically from recommendations in his official writings. One might say that despite what he wrote, Freud's position during the analytic hour was somewhat very elastic, if not downright wild at times.
Severn, was a working American psychotherapist who came regularly to Budapest for chunks of intensive analysis with Ferenczi. A number of her own psychotherapy clients went to Budapest with her, forming a somewhat intense "American psychoanalytic enclave" in which everybody talked freely about their emotional problems, the course of their analyses, as well as the shortcomings or heroisms of their analyst. It sounds to me a little like an hyper-extended training weekend. Nevertheless Severn being a self-employed female with no inherited wealth, needed fees from these well-heeled Americans to finance her trips to Hungary.
Before mutual analysis began with Severn, her analysis seems to have become moribund, but with this new technique it began flourishing when her severe -and almost paranoid- distrust of her analyst began to ease. To use Balint's phrase "a new beginning" of her analysis dawned. Like Thorne, in the article I have mentioned often in this series, Ferenzci began working almost without boundaries during his experiments with the technique of mutual analysis. He met Severn for analytic sessions several times a day, at nights, and weekends. She even went on brief holidays with Sandor and Madame Ferenzci. It was perhaps for this intensive pattern of working, that Ernest Jones put the rumour around that Ferenczi could no longer hold professional boundaries and had become psychotic towards the end of his life. In fact he was suffering from pernicious anaemia: an illness which eventually killed him. Along with his stretching of traditional techniques and the traditional analytic clientele, Jones insinuated that Ferenczi was simultaneously stretching himself beyond the point of physical collapse into paranoid psychosis.
Ferenzci and Madame Ferenzci with Severn Public Domain |
It is not surprising that Fernenzci canvassed the idea that exhaustion was an indicator that an analysis was approaching termination. As in the recent pandemic, there are doctors, nurses, therapists who were greatly admired for their dedication above and beyond the call of public duty. This situation becomes insidious when such altruism becomes demanded or expected daily -whether by patients, national health managers, and of course oneself. Of course one must never be blind to the fact that all clinical work has its own jouissance which may include deathly pleasures and destructive actions. But even Ferenzci's clinical altruism at time became exhausted, forcing hims to recognise that he, and perhaps his clients, had talked enough. With Severn, Ferenzci seems to have both benefited and then exhausted the possibilities of mutual analysis. He then encouraged Severn to resume regular psychoanalytic technique about which she was initially a little ambivalent.
For Ferenzci exhaustion involved having
- thoroughly explored all available options many times and in considerable detail
- worked through new perspectives or perceptions gained in analysis during several cycles of talking sessions
- become fatigued, fed up, or physically and emotionally drained.
6 Final contributions to the problems and methods of psycho-analysis. (Mosbacher, Trans.). USA Basic Books on Psychiatry 1955. The following chapters:
John Rickman
The Criteria for the Termination of an Analysis Int. J. Psycho-Anal., 1950/ 31:200ff
dissolution/de-solution/desolation
As soon as I returned, a flareup of asthma prompted doctors to advise me to isolate myself at the end February (2019). So what had been ordinary, everyday, life was not available any more .....and for millions of other people too. In my thirties I was professionally involved in early the Hiv/Aids crisis. This had prepared me to understand how often medical science can lag behind the advances of a clever virus.
I suppose the death of my father, the beginnings of an international pandemic, and "self isolation" brought to mind this account of endings found in Lacan.
"People Born 1940-1970 (With No Life Insurance) Should Claim This Benefit In July 2021"
This piece of unsolicited information came from a sponsor called "Quote SearchDeals", enquiring what my life would be like if could have a £200k life insurance policy for just £10.00p per month. This sponsor also left all sorts of marks, links, punctuations, formatting instructions, and other garbage on this blog which took me ages to eliminate.
In retrospect I am glad about this because it allowed me to expand what desolation may refer to:
1. the action of desolating
2. grief, sadness
3. loneliness
4. devastation, ruin