The Relationship of Preconscious Mentation to Therapeutic Advances

In the course of an analysis, the changes that occur in the patient's life are far more extensive than can be explained solely on the basis of conscious communications between patient and physician. Even in the most intensive analyses, the number of hours of consultation are precious few in comparison with the time the patient spends confronting the vicissitudes of life on his or her own. I wish to consider the hypothesis that patients carry away from their analyses a preconscious method for dealing with conflicts, which to varying degrees may or may not become conscious, but nevertheless provides for adaptive changes.

When I was 28 years old, nearing the end of my own analysis, I had the following dream soon after my analyst had gone away for a six-week vacation.

I am lying on a couch in surroundings very similar to my analyst's office. Behind me sits Dr. Archer, an acquaintance, whom I vaguely know. I begin to explain to him why I have been having anxiety over the prospect of my future visit with him. It is because he reminds me of my father. I suddenly feel an unburdening and no longer dread the meeting I am to have with him.

Freud made it clear in his Interpretation of Dreams that cognitive processes which appear as part of the manifest content of a dream are not in themselves examples of cognition in the act of dreaming, but rather are carried over en bloc from the preconscious residues of the day's thoughts. I find this thesis entirely consistent with the following interpretation which I offer. At the time I had the dream I was in fact going to visit a Dr. Archer. He was a colleague of one of my teachers and had agreed to show me around the university where he worked as I was applying there for a residency. During the few weeks before my visit I had an unexplained apprehension about spending time with the man. Two days before my visit, I had the dream and woke up with my anxiety considerably diminished. The visit with Dr. Archer