Loss: a central theme in psychotherapy.

Abstract

As an essential aim of psychotherapy is to change in order to develop and grow the patient has to give up some mal-adaptive patterns of behaviour and out-of-date values and belief systems. The inevitable losses involved in this process are discussed in detail. The losses the patient has to face when entering therapy are considered first, followed by consideration of the losses he encounters when during therapy he has to change his attitudes towards himself and others, including the giving up of infanitle wishes and illusions and of value systems originally imposed upon him from outside sources. The losses and disappointments he experiences in the therapeutic relationship itself are discussed, and attention is focused on the way in which what is at first experienced as a loss can become the starting point of new developments and lead to a more positive acceptance of his psychic and physical functioning. To achieve these aims the therapist himself needs to learn to adopt a similar, positive attitude towards the losses and limitations involved in his own life experience and therapeutic work.