You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
This is a formidable assignment. To meet this, it is tempting to use the usual psychoanalytic cliches and, with broad colorful strokes, generalize with such appealing notions as success, fulfilment, love, insight, real understanding, the real core, freedom, independence, etc.
Another approach is to focus on the complex nature of this assignment, and to consider ways in which we can eventually answer this challenge with more discipline, empirical exploration and observation. Toward this end, let us consider some alternative notions of the meaning of change, theoretical concepts such as ego, self and identity, factors that influence change, and what work needs yet to be done to refine this clinical investigative approach.
What is meant by change? It is not possible to document how many different and valid versions have been used to explain this in psychoanalysis. However for the purpose of illustrating my point, I offer four alternative, frequently used meanings of the concept of change associated with psychoanalytic experience.
This is a verbal formulation of phenomena that have been going on and continue to go on in essentially the same manner except that now the actions are translated into word pictures as well. There is no denying that some people experience what amounts to psychotherapeutic relief simply by formulating a verbal picture of what they have been doing. A minor modification of this concept of change is the verbal reformulation which enables the patient to continue with the same dynamism as before, but because of the reformulation he is able to rationalize his actions in such a way that conflict is no longer an issue. For example: “I no longer worry about my compulsion to eat an egg every day because I now realize that this is my way to defy my mother and maintain my independence.” These people are prone to talk a great deal about “how wonderful” psychoanalysis is.
Another meaning of the concept of change is that the patient accepts the b