Stages of forced termination: uses of the death metaphor.

Several patients undergoing forced termination appeared to experience a series of staged reactions similar to those described in dying patients. On the basis of this parallel we explored the effects of using the specific clarification that the ending of therapy was similar to a death. This technique appeared to effectively free up those patients who were stuck in a particular stage of the process so that they could complete the termination. Supporting case material is presented and the clinical implications of this innovation are discussed.