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Wallach, H.D. (1961). Termination of Treatment as a Loss. Psychoanal. St. Child, 16:538-548.

(1961). Psychoanalytic Study of the Child, 16:538-548

Termination of Treatment as a Loss

Helen D. Wallach, M.D.

The therapy of an eight-year-old boy, Billy, provided an opportunity to study the termination of treatment as an experience of object loss. This boy's reactions illustrate in a particularly vivid manner phenomena which occur with less intensity during the termination of many cases because his mother's early death had made Billy especially vulnerable to the loss of a woman with whom he had a relationship.

His reaction to the loss of his female therapist was the more intense, since termination was not then therapeutically indicated, but necessitated when the therapist left the clinic. The early loss of his mother had not yet been adequately worked through. This unfortunate circumstance, the premature termination, gave ample evidence that this child experienced current losses as a recapitulation of his earlier traumatic experiences. Loss had so distorted his identification, his oedipal conflicts, and particularly both his castration fears and wishes, and expectation of loss had become so much a part of his character, that only prolonged therapy or analysis might have altered this basic constellation.

Billy was seen regularly once a week for ten months and twice a week for another ten months in psychoanalytically oriented play therapy. The loss of the therapist became a major reality during the last three months of therapy.

Billy was originally brought to the clinic at age six by his stepmother and father. They had many complaints.

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