'The Unexamined Death': Patients' Experiences of the Premature Termination of Analysis Due to the Sudden Death, or Terminal Illness, of the Analyst

Background: From personal experience, plus a brief overview of literature, the researcher surmised that the potentially traumatic impact on patients of losing their analyst to terminal illness/sudden death had received scant attention from the psychoanalytic community. Listening directly to patients (as opposed to analysts) had been particularly overlooked. Literature Review: This initial hypothesis was confirmed/refined by this Review: it was felt that focusing on the account that patients gave of their experience would be the most appropriate means of eliciting information. Knowledge that would assist the psychoanalytic community to most effectively ensure the wellbeing of future patients. Methodology: Interpretative Phenomenological Analysis (IPA) seemed to most appropriately meet the aims of this research. 14 semi-structured interviews were conducted, allowing the flexibility in questioning that is an inherent characteristic of IPA. For consistency collecting, transcribing and analysing of data were undertaken by the researcher. Accepted ethical procedures were followed. Findings and Discussion: Five Superordinate Themes emerged based on 21 Major Themes – Changes in Analysis before Termination; Aftercare in Relation to Outcomes; The Inherent Nature of Analysis inc. Requirements of Analytic Training; Emotional/Psychic Effects; Experience Utilised. Within these 5 Superordinate Themes issues/dilemmas were identified that were detrimentally affecting, in some cases seriously, patients’ wellbeing. The majority of these issues had been identified, in some form, over the past 50 years but not adequately acknowledged/acted upon. Some new issues emerged, including problems that are occurring in the interface between formal executors and sick analysts. Suggestions were given that might be helpful for the profession to take forward. Conclusions: The researcher has separated out the variables that appear to affect the outcome for patients into those that are largely ‘fixed’ as opposed to those that are ‘more malleable’ and urges the psychoanalytic community to act speedily on the latter.