On Human Relationship and Loss

I only caught a few minutes of the Forum program with Louis Breger, a psychotherapist and author of a new memoir about his work. And what I heard I just have to comment on. A caller spoke of entering psychotherapy treatment with abandonment issues and how the psychotherapist said to her that it would only be she (the patient) who would leave this relationship (meaning that the therapist would never leave her). I was dismayed to hear that that is what the psychotherapist said and equally dismayed by Dr. Breger’s comments. What the program’s guest didn’t say but should have is that what that therapist said to his patient was a clinical mistake. No one, including therapists, can make any such claim as “I will not leave you.” No therapist (or indeed anyone else) can predict what will occur in life: a crisis that requires closing one’s practice, illness, and of course death. Dr. Breger made some comments about how patients with such issues can be retraumatized in psychotherapy. The point that he did not emphasis was the mistake made by the woman’s therapist.

What a psychotherapist can say – indeed what I say to my patients, many of whom are dealing with issues around abandonment – is that what we can do is talk. We can talk about the fears about abandonment and past experiences that contribute to that fear. We can talk about all of the patients’ feelings about our relationship, about coming to rely on someone and fearing the end of that relationship. And as we talk, we can construct over time a trusting relationship which can serve as a model for building other relationships outside of therapy. To a large degree, this is what it means to be human: to have relationships where we rely on others, feel less alone, supported and cared for, and then to experience the loss of that relationship. This is the human process throughout our lives. This most intimate and human of experiences, of course, occurs in psychotherapy. The only difference being that in psychotherapy we can and do talk about it.

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