Setting Up the Doll House: A Developmental Perspective on Termination

Abstract

This article considers the contribution that consideration of the moment-to-moment process in psychoanalysis can make to an understanding of termination. Information on moment-to-moment interactions related to termination is developed from videotape microanalysis of termination discussions—focusing on a child analysis, but including an example from an adult analysis—as viewed through the structure of a developmental model (Tronick's dyadic expansion of consciousness model) that is consistent with dynamic systems theory. The theory emphasizes the co-creation of meaning that occurs in an analysis, as indicated by verbal, as well as nonverbal, interactions that are apparent in the videotape. The insights from this approach can enrich the traditional psychoanalytic views on termination by emphasizing the ongoing developmental process, with termination more of an important step in this process than a specific ending.

Notes

¹Examples of important papers on the subject in the 1970s following this trend include Abrams (1978) and Van Dam, Heinecke, and Shane (1975).

²Contributors to the child analytic literature writing in the 1990's challenged that difference, insisting that just as in adult analysis, the “sine qua non” of a child analysis is the development and resolution of a transference neurosis (Chused, 1991; Weiss, 1991).

³The discussion of two child analytic cases in a workshop at a recent meeting of the American Psychoanalytic Association emphasized the importance of resolution of the transference neurosis in the termination phase (Workshop for Chairmen and Faculty of Child and Adolescent Analysis Programs, June 7, 2005).

⁴Other psychoanalytic writers have looked to open systems theory for general principles of psychoanalytic change and of technique (examples are Schlesinger, 2003; Galatzer-Levy, 2004).

⁵Another useful concept derived from infant research and dynamic systems theory, is Sander's (1983) notion of “recognition.” Sander explains that according to dynamic systems theory, the developing infant needs both the experience of “being together with” the caregiver and also the experience of “being distinct from” her. The infant needs to be helped to achieve and maintain adequate regulation by the caregiver, and also needs to be helped to develop competency in initiating his own actions. The former is developed through mutual regulation in the infant–caregiver dyad, and the latter is achieved as the caregiver recognizes the infant's self-initiated actions and competencies. The competence of self-regulation and self-organization becomes an essential part of the infant's sense of agency, and if that competence becomes “an enduring configuration of adaptation in the system, the stage is set for experiencing the continuity of ‘sense-of-self-as-agent’” (Sander, 1983, p. 588). This continuity of self-as-agent could be seen as what a patient carries away after a successful analytic treatment, but it is not unique to analysis. Instead, it results from every successful growth experience. Also it is never completed, but is always in evolution.

⁶Fivaz et al. have shown that infants are capable of triadic family relationship patterns. The constellation of factors influencing the development of Oedipal behavior as it is observed in 3- to 4-year-old children is more complicated. In Laura's case, it is the clinging rigidly to the simpler relationship patterns and the inability to take the risks of trying out alternatives—especially alternatives that include strong affect, intense arousal states—that contributes to her symptomatology.