DIP Critical Reconstruction

Fatigue & the Positive Ending

What does a good ending mean when energy itself is limited?

THE QUESTION: what does good completion mean when someone has fatigue, pain, or nervous-system vulnerability?

From “positive” to “sustainable”

“Positive” can accidentally imply calm, relief, more energy, emotional resolution, or feeling better. A disabled or chronically ill client may finish a genuinely good session still tired, still angry, still in pain, still grieving. A more accurate standard: a good ending does not need to leave the person feeling better. It should leave them no more depleted than the work required, and with enough agency to manage what comes next.

Why this matters more than it might seem

Biodynamic theory rightly emphasises ending emotionally significant work well — with real time for relaxation and settling before a person leaves. For someone with an energy-limiting condition, the stakes of getting this wrong are higher than usual: a poor ending can genuinely cost several days of recovery, not just an uncomfortable afternoon.

Where the standard closing sequence can fail

A typical closing sequence — slow movement, deeper breathing, stretching — can actively cost more energy than it restores for a body managing chronic fatigue. Applying it as a default, regardless of fit, can leave a client worse off than if the session had simply ended without it.

A lived scene · fictional teaching example

A client has ten minutes left. The therapist notices they look tired and thinks, “let’s do a grounding exercise before you go” — ordinarily involving posture, breath and gentle movement. The client says instead: “actually, I need to stop talking now and save enough energy to get home.” That is the grounding intervention. No extra exercise is needed, and adding one would undo the point of it.

A process: Budget → Notice → Close early → Support → Leave

Budget: what energy is actually available today, before the session even begins?
Notice: what signs tell the person they are approaching their limit?
Close early: don’t wait for visible exhaustion before starting to wind down.
Support: what is actually restorative for this person, which may not be movement at all?
Leave: what does the rest of the day require, practically, for them to get there safely?

What a genuinely good ending can look like

Real stillness rather than active movement. A session that ends before exhaustion sets in, rather than one that runs until it does. A direct question — what do you actually need right now to manage the rest of today — answered honestly, and followed.

The session should not consume the energy required to survive the journey away from it.

A question worth carrying

Would this closing sequence actually restore this person’s energy — or would it cost more than the session gave them?

You may also want to explore

The Positive Ending · Rest as Self-Regulation · Biodynamic Psychotherapy & Disability

From the inside

Endings for tired bodies

With cancer treatment or ME/CFS, a good ending may mean stopping before exhaustion. With Parkinson’s, it may mean ending before medication wears off. With dementia, a familiar closing ritual can carry the session’s safety forward.

Evidence & sources

Sources checked in October 2026, using targeted searches rather than a systematic review. “We have not located” means our searches did not find it.

Established theory

For an overview of Biodynamic psychology: “Biodynamic psychology”, in The SAGE Encyclopedia of Theory in Counseling and Psychotherapy.

Key text

Young, C. (ed.) (2022), The ‘New’ Collected Papers of Biodynamic Psychology, Massage & Psychotherapy. Body Psychotherapy Publications. Gathers Gerda Boyesen’s and later Biodynamic writings.

Our framework

The disability reconstruction on this page is this site’s own synthesis. It has not been formally tested.

Fictional example

Any scenes, case studies and therapy dialogue on this page are constructed for learning. The people in them are not real.

Not yet known

Our targeted searches did not find controlled outcome trials of Biodynamic psychotherapy or Biodynamic massage, or studies designed around disability.

Last reviewed: October 2026.

How to cite this page: Donaghey, C. (2026). Fatigue & the Positive Ending. Disability in Psychotherapy. Available at: https://disabilityinpsychotherapy.online/what-is-psychotherapy/body-psychotherapy-disability-lens/biodynamic-psychotherapy/biodynamic-psychotherapy-and-disability/fatigue-and-the-positive-ending/ (Accessed: [date]).

Shared under CC BY-NC 4.0, with extra permissions for teaching, supervision and therapy. Credit the site. See Reusing This Material.