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The topic “What is Effective in Psychoanalysis?” is of rather staggering magnitude. It left me temporarily in helpless bewilderment. After all, all tools of psychotherapy, the whys and wherefores of psychoanalytic technique and the concepts of psychoanalysis
would seem to belong in this mammoth challenge.
We know a great deal about factors leading to therapeutic results in general. Yet there is still a great need to evaluate the factors that make for change in specific therapeutic situations. We need to scrutinize and learn from the subtle and always varying dynamic interaction of each psychoanalytic therapy. Each therapeutic hour presents many subtle variables of approach. We may be aware of a few of these and choose one. This is the area of therapy which is often shrouded in a diffuse, pleasant mist by words like “art” and “intuition” to explain the therapist's skill.
We need greater clarity, although not by increasing the invariably too-rigid pronouncements of technique. The student in the field has to learn by formulation, categories and principles in order to master the complex wealth of material. But he also has to learn to respect the infinite variation that is the human being. He must know that no two patients are alike, nor any two therapists, nor any two therapies. The detailed observation of a therapeutic situation will teach us an increased awareness of the variables of therapeutic interaction and will increase our resourcefulness and understanding of other patients. It will not, however, provide us with an answer which we can apply, unmodified, to another situation.
Our literature contains a rigid concern with the inviolateness of certain rules of therapeutic conduct, but it also reflects the creative search for a more effective therapy based on the humility that comes with an appreciation of the size of the task. Certainly the problems of technique that Sandor Ferenczi1 and Wilhelm Reich2 wrestled with in the twenties and early thirties remain with us st