Download Author: Kupers, Terry A. M.D.

21 eBooks available.

Freud on Termination

Freud could be brilliant in his theoretical discussion of termination—an abstract discussion about when the natural point to end arrives—but he seemed less capable of helping his analysands with their actual feelings about the loss.

The Termination of Psychoanalysis after Freud

This chapter is in two parts: the first deals with specific developments on termination as expressed in the literature, the second with changes in the theory and practice of psychoanalysis that radically alter the meaning of termination.

The Clinical Logic of Termination

This chapter will serve as the transition from the purely clinical discussion to one that integrates the clinical and the social levels. The concept of a clinical logic touches on both.

The Brief Therapy Alternative

There are three reasons for including a chapter on brief therapy in this discussion of termination. First, the time limits imposed by brief therapists tend to exaggerate certain termination issues. Second, it is an opportunity to make the discussion of termination more inclusive. The third reason for including a chapter on brief therapy is that it serves to expose the contradiction between the clinical logic of termination and the fact that means more than clinical condition seem to determine the length of one’s therapy.

Therapy in Pieces

More and more, clients enter therapy wishing to work through one or another circumscribed issue, end the therapy when they feel satisfied with the immediate results, and then return to be in therapy again when another crisis arises. It is hard to say which came first, the brief therapy or the pattern whereby more and more people begin to utilize therapy in pieces over a life time. Whichever it is, the whole meaning of termination changes.

The Community of Therapy Consumers

The growth of a community of willing therapy consumers significantly influences the way termination is theorized and conducted. Therefore the discussion of termination must take into account the culture of therapy consumption.

Ending Therapy: The Meaning of Termination

Recent articles in the popular press reveal a disturbing picture of psychotherapy: greedy, unethical, or perhaps simply ignorant therapists fostering dangerously dependent, financially draining, needlessly lengthy relationships with their patients. An integral part of the therapeutic process, termination has rarely been the focus of clinical discussion. Does therapy go on too long? How can its success be judged? What do therapists say about ending therapy? In this important volume, psychiatrist Terry Kupers confronts these questions, exploring when, how, and why therapy ends. (222 pp.)

Crossing and Redrawing the Lines

Masculinity is all about the lines a man must not cross, and men do not stray very far outside the lines. If we are to change traditional notions of masculinity for the better, we have quite a few lines to cross, and we will have to do something to change the way men are ostracized for crossing lines. We can begin by examining the ways lines are traditionally drawn.

(60 pp.)

Public Therapy:The Practice of Psychotherapy in the Public Mental Health Clinic

“There is a double standard in the distribution of mental health services,” Terry Kupers observes in his introduction to Public Therapy: The Practice of Psychotherapy in the Public Mental Health Clinic. “An overwhelming majority of therapists practice in exclusive white communities while public clinics, which are generally the only mental health services available in minority and low-income communities, are severely underbudgeted and overcrowded.”

It is hardly surprising that such conditions exist in the public clinic, which must treat anyone–whether by personal choice, as a follow-up to psychiatric hospitalization, or by referral from police, courts, or local physicians–who cannot afford private therapy. Waiting rooms become jammed, public therapists see clients briefly, and many must resort to medications and involuntary hospitalizations that serve more as social control than as effective treatment. Moreover, those therapists who decide on a lucrative private practice often rationalize their preference by contending that the poor lack not only the means to pay for psychotherapy but the intellectual and emotional resources needed to respond to it.

Kupers challenges the conventional view concerning therapy for the poor, showing that many low-income clients–including those who have been labelled “chronic” or have long been treated solely with tranquilizers–can benefit tremendously from dynamic psychotherapy. He does not, however, minimize the daily obstacles that face therapists who practice in a public setting. Indeed, one of his primary concerns is to introduce a wide readership to the hard realities of the public clinic and, through case histories, to the plight of low-income clients.

Sharing the ideas and techniques he has developed from years of community mental health experience, Kupers discusses issues of critical concern: clients who consistently fail to show up, racial tensions that complicate staff and therapeutic relationships, the effects of social and economic hardships on depression, advocacy as a therapeutic intervention, training in the public clinic, termination, staff burnout, and others. Throughout he avoids medical and technical jargon and attempts to give a strong, vivid description of public therapy’s problems and prospects, its personal and social dimensions.

Public Therapy is intended for psychiatrists, psychologists, social workers, and counselors who believe that low-income clients need and deserve better treatment than can be provided from a bottle of Thorazine. It is also meant as a frank rebuff to those who insist that dynamic psychotherapy is effective only with the affluent.(382 pp.)