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Presented at the Anna Freud-Hampstead Center Symposium held by the Michigan Psychoanalytic Society, November 11, 1978.
ALTHOUGH IT IS GENERALLY AGREED that the development of insight is fundamental to the therapeutic effect of psychoanalysis, it has not been determined exactly how insight is effective. Nunberg's (1937, p. 161) statement still holds:
… any attempt at forming a theory of therapy is bound to prove incomplete and may even involve a number of contradictions.
I hope to raise questions here that may help toward eventually establishing an integrated theory of insight.
No fully satisfactory analytic definition of insight exists. Webster (1965) defines it psychiatrically as "recognition of one's own illness." Concepts of analytic insight have changed as psychoanalytic theory has changed. In terms of topographical theory, during insight, unconscious thoughts and feelings become conscious or preconscious as repression is lifted. With the development of the structural approach, insight was seen to involve the integration into the ego of aspects of the id. Freud's
Where id was, there ego shall be
(1933, p.80) defined the task of analysis. Essentially, insight during psychoanalysis comprises the expansion of the ego by self-observation, memory recovery, cognitive participation, and reconstruction in the context of affective reliving.
It is not certain whether and under what circumstances insight produces a therapeutic effect. Some think it an instrument by which an analytic result is achieved, while others maintain that insight is the result of — a by-product of — an analytic process that is therapeutic in itself. Actually, the attainment of insight does not guarantee therapeutic