The Manifest Content of Dreams

When psychoanalytic treatment starts, the analyst's task is to know the person in front of him: how does this person relate, what ways of relating to others has he learned, what are the main characteristics of his life-style. The essential questions the analyst faces have to do with the quality and the origins of the patient's being-in-the-world.

The process leading to the understanding of the form of existence that a concrete person has developed, as seen at a given moment by the analyst, is not a simple one. It is an experience which evolves slowly and progressively, through the many obstacles embodied in the patient's resistances. Unlike the medical patient, who most often comes to the doctor with factual information, the neurotic often presents as if in a disguise, not wanting to be discovered, and speaking in riddles. Whether consciously or unconsciously, and on the basis of this ambivalence, the patient struggles to conceal his truth. Consciously because guilt and fear plague his existence, and, unconsciously, because the disease itself implies the invalidation of the real self and its usurpation by an other-directed image such as one of compulsive compliance or rebellion.

It is a basic tenet that, dynamically, the elucidation of a neurosis has to occur in the context of the therapeutic relationship, and that the nature of this relationship is determined by transferential and countertransferential processes. It is only gradually that the real identity of the patient emerges, and only at the end of a tortuous therapeutic path. We can then truly glance at the nuclear aspects that had been initially obscured, by the nature of the patient's false presentation as well as by numerous resistances.

It is however crucial to arrive, as soon as possible, at an understanding of the patient's self as well as of his attachment patterns. This is how it becomes possible to steer the treatment, and to establish goals and methods. Based on this, different p