The End of the Hour: A Therapist’s Reflections on Closing a Practice

Abstract

ABSTRACT Choosing to close a private practice carries profound ramifications for therapist and patients. Patients usually leave us through a mutually constructed termination, accompanied by the understanding that the patient is welcome to return. Terminations marked by abrupt rupture are – with rare exceptions – at the behest of the patient. The choice to close a practice based solely on the wishes and needs of the therapist interrupts ongoing work, disappointing and angering patients and stirring up abandonment issues. For the therapist such a decision involves separation from a deeply cherished identity. And, while this choice affirms a measure of control, it also acknowledges intimations of one’s own mortality. This paper addresses the conundrums of choice, the theme of loss and the arc of the work between announcement and termination.