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Firestein, S.K. (1974). Termination of Psychoanalysis of Adults: A Review of the Literature. J. Amer. Psychoanal. Assn., 22:873-894.

(1974). Journal of the American Psychoanalytic Association, 22:873-894

Termination of Psychoanalysis of Adults: A Review of the Literature

Stephen K. Firestein, M.D.

Criteria for Termination

IN DEALING WITH CRITERIA for terminating psychoanalytic therapy, one naturally has to be concerned with ideas of what is to be regarded as emotional health, "normality," and the goals of analysis.

In one of his "Introductory Lectures on Psychoanalysis" (1917), Freud refers to the neurotic individual's return to health in terms of "whether the subject is left with a sufficient amount of capacity for enjoyment and of efficiency" (p. 457). This appears to be the origin of the familiar maxim for assessing mental health in practical terms according to the subject's capacity to love and to work, and basing one's judgment regarding termination upon such an appraisal.

Nunberg (1954) refers to this formulation of Freud's, as well as certain others even more familiar: the aim of analysis is sometimes delineated as "to make the unconscious conscious," or alternatively, "Where id was, there shall ego be." In early contributions, Nunberg (1928), (1931) notes these and goes on to elaborate upon the theory of therapeutic results principally in terms of the synthetic function of the ego, alterations of that function, and the consequences stemming therefrom: In recovery, the ego, not having to expend so much energy in repression, is strengthened for reality testing. "… The energies of the id become more mobile, the super-ego more tolerant, the ego freer of anxiety and the synthetic function of the ego is restored. Analysis is therefore actually a synthesis" (1928p. 119). In further remarks, Nunberg emphasizes that the conscious ego must accept what has heretofore been experienced as alien to it and repressed.

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