Discussions of “Reassurance in Analytic Therapy,” by Douglas H. Ingram

First, I'd like to thank the Association for the Advancement of Psychoanalysis for this opportunity to participate in their scientific program. I also want to reassure Dr. Ingram that I found his paper creative, thoughtful, and educational. Lest you think that this is false reassurance on my part, let me say that since receiving his paper, I have been thinking a great deal about this issue, particularly during my interactions with patients, and in doing so have begun a learning process in an area about which I have previously not given much thought, and which I believe has had too little attention paid to it in the literature—at least from the publication of Alexander Martin's (1949) paper, until Dr. Ingram's presentation tonight. In a sense, I feel that I'm discussing two papers, since Dr. Ingram's paper is based, in part, on Martin's, as he reexamines it and then proceeds to explore the subject of reassurance from his particular point of view.

Let me begin by examining the subject of reassurance within its historical psychoanalytic context. It seems to me that Martin's categorization of reassurance into the three categories of false reassurance, superficial or defense reassurance, and basic reassurance stems from Freud's views on the use of reassurance in analysis. In his paper “Recommendations to Physicians Practicing Psychoanalysis,” Freud (1912) outlines what has subsequently been termed the “rule of abstinence.” He advises his colleagues “to model themselves during psychoanalytic treatment on the surgeon, who puts aside all his feelings, even his human sympathy, and concentrates his mental forces on the single aim of performing the operation as skillfully as possible.” Freud further emphasizes that in order to facilitate and resolve transference, “the doctor should be opaque to his patients and, like a mirror, should show them nothing but what is shown to him.” This is the foundation of classical psychoanalytic technique; that is, the analyst should reveal noth