Psychoanalysis as Therapy Today

Abstract

As has become apparent in each of the preceding chapters, psychoanalysis as a model of psychotherapy invented by Freud shifted its focus away from symptom relief after catharsis of guilt and shame toward character reorganization. Today, symptom relief is not an important criterion for termination of analysis (Firestein, 1978). Intrinsic in this shift has been a change of emphasis away from unraveling the patient’s states of shame and guilt over forbidden longings (as these resonated with childhood longings) toward locating the patient’s psychosexual (instinctual) regression or childhood ego-impairment (as this forecast the present illness). As Freud made these shifts in emphasis he also became less enthusiastic about therapeutic success and more interested in the implications of psychoanalysis for general psychology and the social sciences. As I have suggested in previous chapters, Freud’s diminution of interest in therapeutic success paralleled and may have been influenced by the relatively quick successes he achieved with the ready affects of hysterical women patients as contrasted with slow progress and fluctuating outcome of the work with the obsessional Wolf-Man, that champion representative of the affect of indifference. Whether or not there was a causal connection, Freud’s own (self-fulfilling) prophecy (1926b) was that psychoanalysis would ultimately be more influential in general science than as a mode of therapy.