This is the End

As the New Year approaches, we decided to make a short podcast all about endings, the importance of endings in psychotherapy, and how to orient yourself towards endings (small and large) in your own life.

Audio-Essay by Dr. Alex Curmi. Dr. Curmi is a consultant General Adult Psychiatrist who completed his training in the South London and Maudsley NHS foundation trust. In addition to general adult psychiatry he has a special interest in psychotherapy and mindfulness meditation.

If you would like to enquire about an online psychotherapy appointment with Dr. Alex, you can email - alexcurmitherapy@gmail.com

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Transcript

What's better way to celebrate the new Year than to make a short podcast all about endings? Our lives are a constant series of beginnings and ends. We're often frightened by endings, and yet, with the end of the year, there is a culturally embedded attitude towards celebration. Perhaps because it's obvious that one year ending bleeds into a new year beginning, or perhaps to serve as a buffer against some of the darker aspects of our psychology to prevent a harsh ending, particularly one in the darkness of winter, to turn us towards despair. Because life is so full of endings, it's considered to be a very important part of psychotherapy. One of the hallmarks of psychological maturity is how you can handle an ending, especially one you may not necessarily want or be 100% ready for. In therapy. Therefore, what the therapist does is try to facilitate for the client what is known as a good ending. A good ending in psychotherapy involves a number of things. It includes closure, where both therapist and client feel they can acknowledge and reflect on what they have learned from each other during their time working together. Importantly, it also includes integration. This means not only has the client gain some insights from the work they've done, but these insights have become embodied, have become a part of how the client operates in the world and with other people. And indeed, in the ideal scenario, the client has not only integrated a few insights, but they have to some degree internalize the therapeutic process. In other words, they can now have a therapeutic, non-judgmental conversation with themselves. They can now come up with new insights on their own. They hopefully are less attached to some of the more dysfunctional and destructive voices within their psyche, and may have a helpful, constructive, therapeutic voice instead. 1s Initially, this voice may indeed sound very much like the voice of their therapist, because for many of us, it's easier to project goodness onto another person, like a guru or a therapist, that we can allow ourselves to be guided by. But one day this could fall away, and we can realize that we have cultivated our sense of self sufficiently that we can allow ourselves to be guided, comforted, and challenged by our own voices. A good ending is also one where we process all of the emotions involved. And this could be a mix of positive and negative emotions. When ending therapy, someone could feel accomplished, sad, disappointed, relieves and angry all at the same time. And the good therapist will usually do their best to allow their client to confront and begin to process these emotions voluntarily, not just for the sake of the therapeutic relationship itself, but because these emotions are a window into what we care about. Sadness can inform us about what we have treasured and have lost. Relief tells us about what has burdened us. Anger tells us about how we may have been wronged, or perhaps what we were not ready to handle. 1s Learning to process emotions at the end of a psychotherapy relationship allows the client to be better equipped to handle endings and other areas of their life. Because as we mentioned at the beginning, life is full of endings, small and large, even though small endings such as the end of a party, the end of a holiday, the end of a journey might be relatively easy to tolerate. We can still recoil from them because they can remind us of larger endings in the distance, the ones which haunt us from the future, the end of important relationships, the end of our ability to perform, the end of certain possibilities. And of course, these are all ultimately framed by our mortality, the ultimate end, our fear that there will be a total end to our experience. If we let these fears overtake us and dominate us, we will have a bad relationship with endings, and having a bad relationship with endings makes life very difficult. It's one of the things that makes people avoidant, angry, or melancholic for long stretches of their lives. Retreating from endings at its extreme is the same thing as retreating from life itself. As Irving Ya'alon, the existential psychiatrist, often points out, the amount of death anxiety people experience is proportional to how unlived one's life has been. In other words, the less someone has engaged with life seriously, the more frightened they will be of dying. And I think the causation here may be bidirectional. Allow yourself to be possessed by a fear of death, and your life will go unlived. Or don't engage with life and you will have a stronger fear of death. And indeed, despite the celebrations we have like Christmas and New Year, which cheer many of us up. Many people have a bad ending to the year and are thrown into stress and despair by our winter holidays, partly because of the fear of endings we just mentioned, but probably for some other reasons as well. There's certainly something about endings which causes us instinctually, if not consciously, to reflect on and make judgments about the past, how we performed, what went right, what went wrong. That's why we have end of the year reviews, Spotify Wrapped, and the best of the years in music, television and film. These media devices resonate with our instincts to judge and praise. This is really quite fun and enjoyable when applied to something innocuous like our music listening habits, but can start to become a lot darker when applied to our personal lives. When considering our personal lives, the doors are open to many aspects of our psychology, including our demons, our tendency towards self-hate or self-criticism, unprocessed events from the past, previous injuries, current resentments and grievances. When the end comes, we may find we have a tendency to judge ourselves in a black and white kind of way as a success or a failure. And it's funny how easily these attitudes transpose themselves on the celebrations themselves. All of a sudden, giving a gift or preparing a meal turns from a joyous act of generosity to a test of our worthiness as a friend, family member, or partner. It's also interesting to note how ends can cast beginnings in a different light. Notice how a twist ending in a film can make you think about the rest of the film entirely differently, or how a perfectly good film can be ruined by a bad ending. This is the idea behind the expression all's well that ends well. The quality of an ending has a defining influence on how we perceive all of the events that came before. That's why it's so important to keep endpoints in the front of our minds and all aspects of our lives. Whether it's a work project, our personal ambitions, our relationships, it's always worth thinking about what kind of ending am I trying to achieve? What happens when things end? What is the exit strategy? This point is mentioned explicitly in the book The Seven Habits of Highly Effective People, where the second habit is to begin with the end in mind. Keeping the potential endpoint conscious is a powerful way of invoking our higher order principles and our values. It throws into sharp relief what we find really important. This is, of course, why people who receive a terminal diagnosis or have a near-death experience often find that this radically reshapes their perspective in a helpful way. The sudden and unexpected intrusion of an ending allows them to separate the wheat from the chaff in terms of what they really care about. All of this being the case may be your reaction to the end of the year, and the beginning of a new one can serve as an interesting litmus test as to how you deal with endings and transitions in general. At this point, it might be worth asking yourself a few questions. What is your reaction to endings in general? Do you feel you're able to tolerate them? Do you feel numb to them? Or do you feel they cause you a huge amount of distress? Do you try and avoid endings entirely? Do you try to undermine them? Perhaps pretend they don't exist, or that they are less significant than they are? 1s What do you think endings reveal about your psychological habits and patterns? It would also be worth asking in times of ending and transition, are you able to confront all of the emotions involved in an ending? One of the strange things about endings is that they often involve a potent mix of positive and negative emotions, as we mentioned earlier. Are you able to process this mix of emotions in all of their bittersweetness? And lastly, knowing how your ear is about to end now, how do you reflect on the beginning of the year? What were your plans, hopes, and aspirations? Did you make any resolutions? Did you engage with life this year? 1s See if you're able to introspect about these questions in a realistic but compassionate way without undue harshness and self-loathing, almost as if you're thinking about a close friend instead of yourself. If you can meditate on these questions seriously, you can then begin the new year with the end already in mind. And this would mean something different for everyone. It could mean you can achieve a concrete goal more effectively, or improve the quality of your relationship, or even just to become more comfortable with yourself and less self-critical. Endings are part of the frame that gives meaning to everything that came before, and it's very important to pay attention to our attitude towards them. The end is not separate from the beginning, but rather they are joined at the hip like night and day, like life and death. They flow into each other. Running away from endings is the same thing as running away from life, and causes us to lead dispassionate and reclusive lives. Sometimes endings are obvious and easy to plan for, and sometimes they are forced on us abruptly. Whatever the case, do your best not to let endings sneak up on you. Whether that involves trying out something you always wanted to try. Finally stopping with the self-sabotaging behavior or telling the people closest to you how you feel about them. What better way to celebrate the New Year than to make a short podcast all about endings? 1s Whether you're a regular listener or this is your first time checking out the podcast. Thank you for spending some time with us this year. We hope you found this podcast valuable, and we look forward to spending some more time with you next year.