Commentary

This discussion presents arguments for two proposed improvements in psychoanalytic case reports—namely, more frequent reports of the whole analysis, and greater emphasis on the presentation of clinical evidence. These two suggested improvements are related, because an important source of clinical evidence—the justification of interpretations—draws on the data of the whole analysis.

Early in his essay, Michels notes that our clinical literature consists largely of vignettes rather than full-length accounts of the therapeutic process, and he asks why this is so. In one of his writings, Freud (1918) asserted that reporting a complete history is both “technically impractical” and “socially impermissible,” and would in any event be “unconvincing” (p. 8). Elsewhere, however (Freud 1905), he concluded that an “intelligent, consistent and unbroken case history” is possible only at the end of a treatment; that completed cases offer the advantage of hindsight; and that definitive interpretation of any fragment must await completion of the whole analysis (p. 18)—in short, “the whole analysis is needed to explain it” (Freud 1911, p. 93; see also Schafer 1986, p. 156; Goldberg 1997, p. 437). Thus, the preparation of a case report is best postponed until the analysis is over.

In his report of the Wolf Man, Freud (1918) referred to still another advantage of waiting until the end of an analysis before writing a report of the case. He indicated that all of the information that made it possible to understand the patient's neurosis “was derived from the last period of the work, during which resistance temporarily disappeared and the patient gave an impression of lucidity which is usually attainable only in hypnosis” (p.11; for similar views on the clarification of pathodynamics during later stages of analysis, see French 1958,