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After four years of psychoanalysis, Mrs. V., now 31, who had sought treatment because she took Valium nightly in order to prevent panic dreams, decided that she was ready to stop the medication. However, as she might well be addicted to the hypnotic after fourteen years of regular use, she appealed for my help to avoid adverse physical withdrawal reactions. She wanted me to establish a regimen because when an internist had attempted to help her gradually withdraw a year previously, he had failed: she had maneuvered him into providing other drugs rather than stopping the Valium. In effect she requested that I institute a parameter. For a number of reasons I did.
Eissler (1953) has stated that in the model technique the analyst's interventions consist only of interpretations. The introduction of any other intervention, which he called a parameter, should occur only when the ego structure of the patient requires it to allow the analysis to progress. Further, according to him, the meaning and effects of the parameter should undergo analytic scrutiny so as to abolish its effects. Adverse results of a parameter include the transference intrusion of the intervention. In addition, the parameter should never exceed the least necessary degree of deviation.
Loewenstein (1957) has challenged Eissler's approach. He observed that there need not be any ego modification in order to employ an intervention other than interpretation. Indeed, what Eissler designates as parameters and Loewenstein prefers calling interventions are not unusual. They are employed in every analysis. One does so at the start of every analysis when