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Richard Fox began by reviewing the historical antecedents in American psychoanalysis regarding the differences and similarities between psychoanalysis and psychotherapy. He noted that a panel on the same subject was held fifty years ago at the Annual Meeting of the American Psychoanalytic Association (Rangell 1954a; Freud 1954; Stone 1954). A key question centered upon the defining elements of psychoanalysis.
The panelists, who included Leo Stone, Edith Jacobson. and Anna Freud, agreed that a psychoanalytic process is defined by structural change occurring after the development of a transference neurosis. They agreed also that resolution of the transference neurosis by interpretation alone is the primary contributant to therapeutic change in analysis. Because psychotherapy does not entail the resolution of a transference neurosis, its benefits were deemed more modest than those of a full psychoanalytic procedure.
Other elements that that panel viewed as definitive of psychoanalysis included significant regression and the absence of parameters. When parameters had to be employed, it was thought, they should be thoroughly analyzed by the end of the analysis. Patients in psychotherapy were believed to benefit from identification with the therapist, not from interpretation and working through of the transference. Fox underscored that in the 1950s psychoanalysis was deemed the “gold standard of treatment” by most analysts, who relegated psychotherapy to a secondary, inferior role.