The Goals of Analytic Therapy

The goals of psychoanalysis have changed in recent years. When Freud made the astonishing discovery that symptoms, such as the paralysis of an arm or anxiety, could be eliminated by calling back to mind the traumatic experience the patient had forgotten, or, as we say, had not gotten over at the time, it was of course the aim of therapy to remove the symptoms. The next discovery Freud made was that this simple method of removing symptoms did not always work. In some cases, no individual experience could be found that was responsible for a specific physical disorder, and it seemed necessary to make a long detour and learn a great deal about the patient's life and his entire personality in order to understand the symptom and help the patient to overcome it. Freud gradually realized the fact that symptoms do not simply vanish but can only be removed if we understand the human personality, and especially neurosis. The goal was therefore redefined as removing symptoms through an understanding of the personality. But the emphasis was still on the symptom.

The next development was that several progressive analysts noticed with surprise that there are neuroses without symptoms. It was Franz Alexander who rather naively named this discovery “character neurosis,” a formulation we feel to be totally wrong today, since every neurosis is a character neurosis; but at the time, the discovery was a considerable advance. What Alexander was trying to say was that neurosis is not only a matter of symptoms but is a disorder of the personality.

We have still not overcome the focus on the symptom, however. Because an enormous number of people suffer from neuroses, it is only natural that the doctor should look for a short way to free patients from desperate situations, from depression, insomnia, alcoholism, or whatever the symptom may be. It gives him the feeling, justified to a certain extent, that at least he did help. The fact that short-term therapy plays such an enormous role is due t