Customer Service | Help | FAQ | PEP-Easy | Report a Data Error | About
Tip: To share an article on social media…

PEP-Web Tip of the Day

If you find an article or content on PEP-Web interesting, you can share it with others using the Social Media Button at the bottom of every page.

For the complete list of tips, see PEP-Web Tips on the PEP-Web support page.

Glucksman, M.L. (2011). Patients Who Stay. J. Amer. Acad. Psychoanal., 39(1):189-197.

(2011). Journal of American Academy of Psychoanalysis, 39(1):189-197

Patients Who Stay

Myron L. Glucksman, M.D.

For Freud, the ideal goal of a successful analysis is to resolve unconscious conflicts, gain insight, strengthen the ego, modify pathological defenses, contain irrational superego demands, and work through transferential distortions. Termination is based on a satisfactory approximation of these goals. However, there are certain patients who are unable to achieve these therapeutic goals. They include those with severe personality, psychotic, mood, eating, chronic posttraumatic stress, and gender identity disorders. For many of them, perseverance of symptoms, impaired functioning, and maintenance medication preclude termination, necessitating ongoing or intermittent treatment. On the other hand, there are those patients who make significant therapeutic progress, but remain in treatment indefinitely. Many of them approximate the criteria for termination, but maintain a therapeutic relationship for a variety of reasons. These include: unresolved transference-countertransference issues, avoidance of separation, chronically stressful situations (work, interpersonal, illness), lack of an external support system, and gratification from ongoing intrapsychic processing. Although nontermination may be associated with pathological dynamics for both patient and therapist, it may also be connected to non-neurotic, realistic factors. In some cases, indefinite treatment may be preferable. A clinical illustration is provided.

[This is a summary or excerpt from the full text of the book or article. The full text of the document is available to subscribers.]

Copyright © 2019, Psychoanalytic Electronic Publishing, ISSN 2472-6982 Customer Service | Help | FAQ | Download PEP Bibliography | Report a Data Error | About

WARNING! This text is printed for personal use. It is copyright to the journal in which it originally appeared. It is illegal to redistribute it in any form.