Emphasis on the Healthy Aspects of the Patient in Psychoanalysis: A Round Table Discussion

At the annual meeting of the American Psychiatric Association in May, 1952, Dr. Karen Horney was the moderator of a Round Table entitled “Constructive Forces in the Therapeutic Process.”¹ At that time she stressed the central significance of human constructiveness for therapy. Based on her clinical experience of an innate urge in all of us to move toward greater self-realizing, she reaffirmed her belief that human beings can continue changing and growing as long as they live. “The therapist,” she said, “must continually support what is constructive in his patient, while helping him undermine all that is neurotic and obstructive to the fulfillment of his potential as a unique human being.”

The neurotic person is distorting or perverting his energies to ends which oppose his growth and lead in self-defeating directions. It is the analyst's task to help the patient to an awareness of whatever is destructive, and to encourage the patient's interest in any available constructiveness. Through the analytic relationship and the analytic process the constructive energies are reclaimed and used for the purpose of a realistic development of the person's potential. As in any branch of medicine, we have found that the patient is best able to attack and withstand the disease process when there is a firm ground of health on which he can stand. Any therapy, then, is dependent upon both the nature of the pathological process and the nature of the healthy process. Psychoanalytic therapy, therefore, must be based on a clear awareness of the assumptions from which the analyst views health and sickness.

Psychoanalysis concerns itself with the ways in which a person relates to others, the ways in which he works and develops his own potentialities, and with attitudes, values, ways of perceiving and understanding. In short, psychoanalysis is concerned with the personal view of the world that the individual's inner structure creates. Our panel this evening will focus on the elements of health