Blessings

City Bakery Melted Chocolate Cookie-Part Cookie, Part Chocolate Bar

I've gone back and forth on whether to write about the termination of my analysis, after the fact. I did write about it in Termination, before it happened. Somehow, this is harder.

So, my analysis ended. The last session was difficult and confusing, and probably will remain confusing for a long time.

First, there was the cookie saga. I decided to get my analyst a parting gift, and since it's impossible to encompass the entirety of an analysis in one object, I decided on cookies. I wanted a specific kind of cookie from a specific bakery (the melted chocolate cookie from City Bakery), but then I wasn't sure I'd be able to get that kind of cookie, so I baked my world-famous-awesome brownies (see This Post for the recipe), but then I felt uncomfortable giving her something I baked myself so I went back to the original cookie idea. And all of this got experienced, acted out, and narrated in the last few days of my analysis.

Another thing I did in the last few sessions was talk about all the things that made me uncomfortable about the process of terminating. Like which words my analyst would choose to end the last session, and how I felt about the intimacy of shaking her hand when I left.

Yet another thing I did, as a larger gesture, was make a blessing. Having been raised as an Orthodox Jew, many, if not all of my fundamental references are Judaic. And one thing observant Jews do is make blessings, which follow the specific formula of, "Blessed are you, lord our God, king of the universe, who is/does something." The italics are the part that varies.

There are blessings for all kinds of things, from rainbows to acknowledging scholarship to thunder to hearing bad news. There is a blessing for every type of food, categorized in very specific ways, of course, but pretty much everything is covered: bread, wine, potato chips, strawberries, and yes, cookies. And even though I'm not as observant as I was growing up, I still make blessings over food. It's a way of reminding myself that I am privileged enough to have food.

In the last few weeks of my analysis, I tried to think of a suitable blessing to make over termination. It was tough. One idea I had was the blessing parents make when a child becomes a Bar or Bat Mitzvah, which goes something like, "Blessed are you....who has removed this one's punishment from me." It sounds awful in translation, but simply means that the child has attained an age at which one begins to take responsibility for ones own actions. That has something of the right idea for a termination, but I told my analyst it seemed more suitable for her to say about me, than for me to say about her.

A friend suggested a blessing about healing a broken heart, which was pretty good, but not quite right.

In the end, I invented my own blessing. It's based on the prayer that's said at funerals and other types of memorial events, such as a Yahrzeit (anniversary of a death), which seemed suitable, since termination has an element of death to it. The end of the prayer translates to something like, "...May he rest in his resting place in peace..."

The Hebrew word that's translated as "resting place" is Mishkav, which literally means, lying-down place. Like a couch. So I used the same word but tweaked it a little to, "Blessed are you, lord our God, king of the universe, who raises (me) up from the couch in peace."

For me, it captures the idea that I leave not "cured", but in more peace than I was in when I started.

So the last session went something like this:

I came in and handed my analyst a bag with the gift. She laughed and asked if these were the brownies or the cookies. I told her they were the cookies, but then I felt bad. Maybe she really wanted to try my world-famous-awesome brownies, and I could have brought both those and the cookies. Oh well. There went that opportunity.

I felt like I should say something momentous that encapsulated the entirety of my analytic experience, but all I could think to say was that my analyst had been very kind. I felt like she should say something broad to summarize our work together, but she just said she'd enjoyed working with me. She also said the door is always open, should I wish to return. I felt like that was decent of her, but it made me wonder if she thought I might not be able to manage on my own.

In the middle of the session, I silently made my blessing, then told her I had made it.

All the old doubts were right there. Have I done enough? Can I manage on my own? Does she like me? Can I share the things I'm inclined to keep to myself? Is she disappointed that I didn't bring her brownies? Can I tolerate the pain of this separation?

It was like a miniature version of my whole analysis, reliving all these feelings that I had grappled with over the years, and made some kind of peace with, only to re-experience them right at the end.

There was a lot more laughing than I had expected, on both our parts. I felt like my preemptively bringing up my discomfort with her final wording, or with shaking her hand, had lessened the pain of those experiences, but also lessened their power. They became more awkward than sad, and I wondered if she was feeling sad too, but was uncomfortable showing it, or felt it was inappropriate to let me see her feeling that way, and maybe the laughter was more nervous than fun. I was disappointed that she wasn't obviously sad. I might have been more disappointed if she had been.

In the end, she said, "We do have to stop." And she laughed. I smiled. I got up, walked to the door, and we shook hands with a quiet, nervous laughter. And then I left.

It wasn't our best session. It wasn't our worst session, either. It was just one of many sessions. I'm grateful for my whole analysis, and I'm also glad, and sad it ended.

So, cookies for closure, discussion for honesty, and a blessing for peace.

Amen.

Termination

Nothing has distracted me from getting things done lately more than the fact that I'm terminating my analysis at the end of the month. This is not new information for me. I started talking about terminating last Fall, and the date was set at least six months ago. But none of that prepared me for the extent of the mourning involved.

Or the craziness. What other human relationship do you end just when it's starting to go well? And the real point is, I'm the one who's ending it.

This is supposed to be a good thing. And that's how it felt when I started discussing it last Fall. I came in one day and said, "I think I'm done." Not in an angry way, as I've felt in the past when something had come up that was upsetting or hard to think/talk about, or I felt like I was being criticized, and I just wanted to leave. And not in a hopeless way, as though there was no point continuing because nothing was ever going to change.

It just felt like I'd gotten a lot out of the experience, including the fact that I could take it from here. I certainly didn't feel "cured", or no longer neurotic. I just felt like I wouldn't be overwhelmed by expectable life circumstances, or even unexpectable ones that aren't too horrible, and I could handle my anxiety and my weird worries on my own.

Or well, not quite on my own. It's like my analyst has become part of me, so I don't need to go to sessions anymore to do the work, and I can manage my own reality checks.

Yeah. A good thing. Exciting, even. An accomplishment.

And let's not forget about the tangible benefits. Like more time freed up, and more money, both from not spending it on sessions, and not taking time for sessions, and the commuting to and from sessions, that could be spent seeing patients.

And what about the relief? Analysis is painful. It forces you to look at things you've been hiding from your whole life. Four days a week.

These are the things that make termination appealing, aside from the fact that termination is the ultimate goal of the treatment.

I want to share a few quotes from a paper by Glen Gabbard, What is a "Good Enough" Termination? (2009. Journal of the American Psychoanalytic Association, 57:575- 594):

...we lack a paradigm for termination. This is as it should be. There are multiple scenarios that are “good enough.” (p. 591)

“Termination,” as opposed to the ending of an analysis, generally implies that the analysis has come to an end through mutual agreement and negotiation by patient and analyst rather than by a financial setback or an unplanned relocation of the patient. There is also the implication that patient and analyst must allow sufficient time to work through the patient's feelings regarding the loss of the analyst and the changes that have been made in the course of the analytic work. (p. 578)

...the interpretive resolution of the transference neurosis, the eradication of symptoms, the achievement of “full genitality,” the modification of the superego, and the ability to love and work are often clustered together as indications for a termination process that will take several months and be mutually agreed on... [However]...terminations are based not on predictive theories, but on permissive models that are reinvented each day.

We must accept that no analysis is complete—rather, a process is set in motion. Orgel (2000), in a thoughtful contribution on the reality of termination, asks poignantly if any analysand ever ends analysis with an emotional conviction that it is complete. Kogan (2007) notes that “there is no such thing as an ideal termination; the symptoms never disappear completely; the patient does not achieve all of the structural changes one would like; nor does he manage to acquire a totally integrated personality”...The terminated patient is not “fully analyzed”—he or she is simply embarking on a life of self-analytic reflection that offers depth and richness to one's existence. Suffering, intrapsychic conflict, and problems in work and love will continue. A tragic vision is central to the psychoanalytic journey. (pp. 585-6)

...both analyst and analysand must disentangle themselves from a significant connection with another human being that has shaped their lives. To some extent analyst and analysand lose themselves as separate individuals in the analytic experience, and it is only through termination that each “retrieves” a sense of being a discrete mind (Ogden 1997). Both parties are different from what they were when they set out on the analytic journey, however, and the mind retrieved is not quite the same as the mind that began the analysis. (p. 587)


Excitement and accomplishment are all well and good, but still, I'm in mourning. Analysis has structured my days and weeks for a very long time. Even my years-the August break is always there, along with some time off at Christmas/New Year, Spring break, Thanksgiving, etc.

The sessions are clearly delimited, and almost always end with the statement from my analyst, "We do have to interrupt," which I find pretentious, although I understand it makes the point that an analysis is really just one very long session with lots of commercial breaks. I'm dreading what she's going to say at the end of the last session. "We do have to terminate," maybe? "It's time to terminate?" "It's time to stop?"

Whatever the phrasing, it's a little bit heartbreaking.

I'm losing the place I go to deal with all the built up frustration and pain. And even though I often clam up when I'm there, I still know it's my time, set aside from the rest of the world.

I'm losing the place that taught me it's okay to look at anything about myself and not feel ashamed or guilty in doing so.

I'm losing an important person in my life. I don't really know her. I know just this one aspect of her. But there is still tremendous intimacy, and I leave with the conviction that, to quote a friend who finished his analysis several years ago, there's someone in my corner. And that someone cares what happens to me.

Of course, there's the weirdness that I'm ending this intense, intimate relationship with this person, but I'm still going to see her at meetings, etc. Only there, she'll be an unapproachable stranger. This is not conjecture or possibility. It happened just last week. But unlike last week, I won't be able to talk to her about the weirdness the next day.

So it's not a death. She'll still be around. It's not a divorce. We're not ending because we can't get along. It's not the gradual drifting apart of a once strong friendship. If anything, it's grown progressively more comfortable , and we've developed our tropes and can even joke around at times.

During one recent session, thinking about endings and "nevermore", I brought up the poem, The Raven. It's a terrible poem. Poe is a terrible poet (though I happen to think he's a master of the short story). The content is all sad and morose, but the sound is jaunty. Silly, even. He uses ridiculous words like, quaff and nepenthe. And the rhymes are too perfect. When I mentioned this, my analyst laughed and told me about a New Yorker cartoon with Poe scribbling phrases like, "Shut the door," and "Sweep the floor."

This exchange would not have happened early in my analysis. This kind of relaxed jocularity. Or if it had happened, it would have upset me, as though a boundary had been inappropriately crossed, and my analyst had behaved, "unanalytically". But the boundaries are now long since established, and I've learned that if one of us occasionally puts a toe across, we'll both survive. That it's possible to survive disappointment or discomfort or ambivalence without losing a relationship may be the greatest lesson analysis has taught me.

Which is why it's okay to lose this relationship.