Discussion

I appreciated Dr. Slater's paper so much that it put me in a quandary as to what I could say in my discussion. I feel he did an excellent job in reviewing goals of therapy as they have evolved during the history of psychoanalysis and where we are with them now. It would be much easier if I could find something that I considered factually wrong or something that I could not agree with on a personal emotional basis. However, these things do not obtain, so my discussion must consist of underlining what was said, expounding and expanding, with my goal being the hope of extending the period of exposure to Dr. Slater's ideas by my own manner of expressing them so that they may become even more real, less forgettable—to add to the stimulation he initiated in us so that we might apply his thoughts to our own way of thinking and our own clinical and life experiences.

What I have just described is similar to our goals in analysis and it is also a reflection on how they have been changing. Instead of focusing on the negative, on what isn't there (which is always easier), we are now more concerned with directing ourselves to what is there and how we can help go on in more positive directions so that the impact, the significance, can be translated by the patient into the reality of his own thoughts, feelings and actions, past, present, and future.

The first focus in psychoanalysis, as in the era of modern medicine, was on pathology—what was wrong in the patients. Our concept of health became negatively oriented; it was an absence of disease, instead of looking at disease as an interruption in the natural course of health. I once gave a lecture to a lay group who had been attending lectures on psychopathology and psychoanalysis for quite some time. My subject was “The Pathology of Health,” from the standpoint of attempting to define and illustrate health. It was greeted with deafening silence from a previously active audience. One of the private comments I heard later was that ther