Crises and enactments while ending treatment.

Abstract

The difficulties involved in ending treatment are complex and can present a set of challenges and possibilities for both analyst and patient. When early trauma is part of the clinical picture, ending treatment may very well stir an experience of an earlier attachment rupture or loss. The author presents a case of a long-term analytic patient where an acute enactment crisis occurred causing a pause in ending the treatment. It is proposed that these very 'ending enactments' become necessary, crucially disrupting a bastion (Baranger & Baranger, 2009) formed by the dyad. This tearing/ending of the analytic frame (Bleger, 1967) may, catalyze a 'second look' which revealed a more chronic enactment. Ultimately more deeply buried pieces of the early relational trauma became accessible to the analytic process. The author argues that sometimes this very upheaval is needed to unblock a bastion. Thus, what was sequestered, and unknowable may enter the dyad as an enactment. In this way, insight, and the self-reflectiveness it entails, may occur post-enactment.