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'Living with goodbyes' ending therapy: an exploration of the psychotherapist's task
thesisposted on 26.02.2017, 23:53 by Dow, Rhiannon
The ending is an important event in child psychotherapy. During this phase, earlier unsatisfactory goodbyes are often revived. It is hoped that patients, given the opportunity to revisit these goodbyes in the therapy, will be able to untangle what belongs in the past and what belongs in the present. Ideally, the therapeutic work and its ending should remain alive in the patient's internal world, and can be drawn upon at times in the future, increasing the patient's reflective capacity and their capacity to embrace loss and all that entails (Klein, 195011975). In the historical psychoanalytic literature and training, it is striking that ending therapy receives less attention than it deserves. Ending therapy arouses powerful anxieties for the patient and therapist alike and it seems that avoidance is often sought to defend against these painful feelings. Wittenberg (1999) states that it is because of this that ending therapy as a topic tends to be neglected. To develop a greater understanding of endings in child psychotherapy, a qualitative study was undertaken. Three experienced child psychotherapists registered with the Victorian Child Psychotherapy Association were interviewed about their experience when ending therapy. The semi structured interview explored factors that facilitate and disrupt a "good enough goodbye" in child psychotherapy, and how beginning psychotherapists may be better prepared for this important task. A thematic analysis was applied to the transcripts of the interviews and major themes emerged. These included: death, emotions, holding on and letting go, what facilitates a good enough goodbye, what disrupts a good enough goodbye, the scaffolds that assist the psychotherapist, and suggestions for psychotherapy trainings. It is hoped that these key themes may help better inform child psychotherapy training and in turn assist therapists in preparing to manage the powerful emotions aroused when saying goodbye.