“So what did we really feel about each other?” Reflections on the clinical relationship and outcomes from clients and therapists ending in psychodynamic therapy Dr Jane Woodend MBACP (accred)

Outline of my research I interviewed psychodynamic counsellors and psychotherapists, clinical supervisors and clients who had completed their therapy 38 interviews with 19 participants Free Association Narrative Interviews Research field notes and a reflexive journal Data was analysed using thematic analysis

What my research participants told me about the difficulties they faced at the ending stages of psychodynamic therapy Don’t mention an ending! The strictures of the therapeutic frame can experienced too harshly to be helpful The lack of orientation to the model of therapy used

Therapists’ assumptions about how clients attach to them are challenged   Counsellors, therapists and supervisors reported affectual responses in relation to ending; clients showed a lack of affectual response and gave accounts that were factual and concerned with external factors Strongest attachments were those described by therapists and supervisors in respect of their own therapists and supervisors

The danger zone – qualitatively different to other stages of the relationship   the fear I identified from therapists that their personal feelings might creep in at the ending stages of their work with clients the idea that the end of the work creates a kind of danger zone which is qualitatively different to other stages of the therapeutic relationship Ian Suttie, in ‘The Origins of Love and Hate’ (1935) suggests there is a ‘taboo on tenderness’ in psychotherapeutic work

What helps an ending? “How will it be when we no longer meet?” A more explicit rendition of how the death, loss and mourning, and attachment, models might be considered in relation to endings It is desirable for supervisors to have knowledge of the ending experiences of their supervisees, particularly where there have been sudden or untimely deaths or endings in their personal history Therapists and supervisors both need to triangulate their predispositions towards a particular way of framing endings with the presenting problem and dynamic of the client approaching an end, in order to think about what might be the most useful way ahead