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Dr. Henry Friedman, Associate Clinical Professor of Psychiatry at The Harvard Medical School and Teaching and Supervising Psychoanalyst at the Massachusetts Institute for Psychoanalysis, offered a provocative presentation challenging traditional psychoanalytic treatment's primary focus on intrapsychic conflict and uncovering the unconscious, suggesting that this exclusive focus may inadvertently undermine the quality of a patient's life by overlooking a patient's present symptoms, current life problems, and corresponding life goals. Moreover, Friedman implied that analytic insight alone is insufficiently therapeutic; he instead posed that an emotionally curative relationship between patient and analyst, in which the analyst fully invokes his or her subjectivity, is a necessary ingredient for a successful treatment outcome.
To illustrate his points, Friedman referenced a case presented in Abend's (2005) article, “Analyzing Intrapsychic Conflict: Compromise Formations as an Organizing Principle,” to contrast Abend's more classical treatment approach with his own. The young male patient had grown concerned that his fiancée, who had used her engagement as a reason to quit her dissatisfying job, was spending money excessively and failing to find work elsewhere, despite her promises to do so. Only in his analysis did the patient express doubts about his fiancée's sincerity in her feelings for him, questioning whether she was instead exploiting him financially; however, he did not raise these concerns with his fiancée and continued to accept her spending behaviors and unemployment.
As described by Friedman, Abend's analysis of this case primarily focused on intrapsychic conflict and the ways in which the patient's current relationship with his fiancée was reflective of his relationship with his mother. The patient's mother was described as narcissistic in character,