Saying goodbye: exploring attachments as a therapist leaves a group of chronically ill persons

This clinical report highlights some of the processes arising in a therapy group of persons with persistent and chronic psychiatric illnesses as they cope with the stress of their long-standing therapist's impending retirement. Members were initially disbelieving that the therapist would leave and were also concerned about their future care, particularly in terms of medications. Gradually they were more able to experience their feelings of loss and their genuine caring for the therapist and the group, using higher level defenses and increasing their ability to tolerate strong affects. They became increasingly able to demonstrate empathy, notably in their ability to consider the therapist's emotions. The clinical material also illustrates the therapist's personal involvement, countertransferences and expressions of concern.