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On Ending Treatment: Clinical Considerations (406) 2023S
Tuesday, March 21, 2023, 5:30 PM - 7:00 PM EDT
Category: Courses

On Ending Treatment: Clinical Considerations (406)
Instructors: Dorothy E. Holmes, PhD, ABPP, FABP and Elissa Baldwin Murphy, PhD, LCSW

Description: The word “termination” is inadequate for the various ways in which a psychoanalytic treatment may be concluded.  The word “termination” derives from Freud’s scant work on the conclusion of psychoanalytic treatment.  Some treatments end abruptly, unilaterally, and/or with intense affective aspects and results that fall short of the treatment goals.  At best, “termination” is a shortcut for the variety of ways, satisfactory and not so satisfactory, that treatments conclude.  This course will consider the history of “termination” in terms of older classical views, including but not limited to Freud’s.

More contemporary Freudian and relational/interpersonal points of view will also be considered.  Other dimensions of a treatment’s conclusion will also be studied:  who decides, whether it is planned or not, mutual, or not, or an impasse.  Further, we will study indicators for concluding treatment, and complicating factors such as diagnosis, a history of trauma, and attachment issues. Intersecting identities and oppressions, and aspects of termination particular to children, adolescents, and families will also be considered.

Target Audience: This course is appropriate for intermediate to advanced students, as well as clinicians with extensive experience who have the permission of the instructor.

Format: We will illustrate treatment-ending processes and techniques through vignettes provided by the instructor and class members. For each class, each member is asked to complete the assigned readings, be prepared to critique the concepts and identified techniques if any in the readings and to present a brief clinical vignette. The instructor will start the conceptual reviews each time; each candidate should also be prepared to identify and critique a concept and/or practice from the readings each week. We will then move to discussion of clinical vignettes that fit each class. The vignette should illustrate the topic for the class and raise or answer a question or two about the class topic. We should endeavor to achieve a balance in each class between review of literature and discussion of vignettes.

About the Instructors:
Dorothy Evans Holmes, PhD, is a Teaching, Training, and Supervising Analyst in the Psychoanalytic Center of the Carolinas, Professor and PsyD Program Director Emerita at the George Washington University, and Teaching, Training and Supervising Analyst Emerita at the Washington Baltimore Center for Psychoanalysis. Dr. Holmes is widely published on the psychoanalysis of race and gender and currently interrogates dynamic and institutional factors that impede the psychoanalytic examination of intersectionality. Her most recent publication is Holmes, D. (2022). Neutrality is not neutral. JAPA, 70: 317-322. Dr. Holmes served on the editorial boards of the IJP and JAPA and now serves on the editorial board of Psychoanalytic Dialogues. She is the eponymous Chair of the Holmes Commission on Racial Equality in American Psychoanalysis.

Elissa Baldwin Murphy, PhD, LCSW is a child, adolescent, and adult psychoanalyst practicing in Durham, NC. She provides clinical supervision and consultation to clinicians (individually and in groups) and is a psychoanalytic psychotherapy supervisor with the Psychoanalytic Center of the Carolinas (PCC).

Dr. Murphy is a graduate of the NCSU School of Design (BLA), the UNC-Chapel Hill School of Social Work (MSW), the Smith College School for Social Work (PhD) and the Psychoanalytic Center of the Carolinas (Certificates in Child/Adolescent and Adult Psychoanalysis). She is trained as a Circle of Security Parent Facilitator and holds a certificate in Advanced Clinical Supervision from the Smith College School for Social Work.

Dr. Murphy serves as a faculty member and Curriculum Chair for the PCC, is an active member of the PCC Anti-Racism Task Force, coordinates an ongoing study group on Race & Psychoanalysis within the PCC, and has been a lecturer and/or research advisor at the PCC, the Smith College School for Social Work, and the UNC-Chapel Hill School of Social Work.

Where: via Zoom
When: Tuesdays, March 21, 2023 to May 16, 2023 No class April 11th.
Time: 5:30pm to 7:00pm Eastern Time (time subject to change)

CME Credits: 12 / CE Credits: 12 / NBCC: 12 clock hours / All others: Letter of Attendance

Prerequisite: This is an advanced course intended for clinicians who have completed the Core Curriculum. Applicants who do not meet this requirement can register for the course with permission of the instructor.

Training Program Credit: Students who successfully complete this course can earn credit on the Psychoanalysis training program. If there is a course assignment, students must complete the assignment to receive training program course credit.

Continuing Education Credit: At the end of the course, participants must complete the evaluation form to receive continuing education credit. The instructor(s) has signed financial disclosure form and has no commercial support that represents a conflict of interest.

Course Syllabus: Download Syllabus

Registration and Tuition Deadline is March 14, 2023.
$25 Registration Fee is due at the time of application.

Tuition: $315
$235 for students matriculated in the training programs
$290 for residents and graduate students
Payment plans can be arranged with the Administrator

Matriculated students are not charged a course registration fee. Students who register for more than one course in a semester pay only one registration fee. In special circumstances we may accept registrations after the registration deadline, but there will be an additional $20 late registration fee.
Course Cancellation Policy

Course Learning Objectives: Class participants will be able to:

  1. Identify concepts and techniques applied to how treatment endings were espoused by Freud and other early analysts.
  2. Describe and assess the utility of early criteria for terminating treatment.
  3. Explain and critique how the Freudian perspective on termination was elaborated as a mourning process.
  4. Describe readiness to end treatment in relation to good enough accomplishment of analytic goals and to what additional analytic work might be done.
  5. Discuss the complexity of what might be a “good-enough” ending in relation to the difficulties in terminating a positive attachment relationship.
  6. Describe the conceptual differences between relational/interpersonal perspectives and classical ones.
  7. Identify and distinguish between impasse and readiness to end.
  8. Discuss critically whether and how an ending was co-constructed and about the role of self-analysis.
  9. Discuss the possibility/necessity of post-termination contacts with patients.
  10. Discuss how one’s own perfectionistic tendencies as an analyst may interfere in achieving a “good enough” ending to treatment.

CE & CME Information

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint provider ship of American Psychoanalytic Association and Psychoanalytic Center of the Carolinas. The American Psychoanalytic Association is accredited by the ACCME to provide continuing medical education for physicians.

The American Psychoanalytic Association designates this Live Activity for a maximum of 12 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

IMPORTANT DISCLOSURE INFORMATION FOR ALL LEARNERS: None of the planners and presenters for this educational activity have relevant financial relationship(s)* to disclose with ineligible companies* whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

*Financial relationships are relevant if the educational content an individual can control is related to the business lines or products of the ineligible company. -Updated July 2021

The Psychoanalytic Center of the Carolinas has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6518. Programs that do not qualify for NBCC credit are clearly identified. The Psychoanalytic Center of the Carolinas is solely responsible for all aspects of the program.

Contact: [email protected]
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101 Cloister Court, Suite A || Chapel Hill, NC 275614
Phone: 919.490.3212 || Fax: 877.897.4034 ||

Psychoanalytic Center of the Carolinas: Promoting Emotional Resilience by Understanding the Mind Through Psychoanalytic Education, Practice and Service.

Contact: [email protected]