Psychoanalytic Technique and Theory of Psychic Change

In what follows we shall take the view, which we hold in common with many other authors (e.g. Dewald, 1972), that the essential basis of the psychological changes brought about through analysis are changes in psychic structure. We also assume that psychic development throughout life is characterized by structural change, and that the psychoanalytic method is not the only method by which alterations in psychic structure can be brought about. Nevertheless, psychoanalysis represents a very special technique of intervention in development, some aspects of which will be considered below.

In the present context the question of the aims or goals of psychoanalysis is of crucial importance (see Wallerstein, 1965). Our own position is that we aim, in our psychoanalytic work, to bring about the appropriate structural change necessary to enable the patient to reach new and therapeutically desirable solutions to his or her central conflicts, solutions which replace the automatic application by the patient of the unsatisfactory and painful ones. Here we are in complete agreement with Anna Freud who has pointed out that the essential conflicts never change, but only the solutions do. By a new and desirable solution is meant that the patient will, through our interpretations, come to tolerate in his fantasy life aspects of himself which were previously unacceptable to him, and not to act these out in ways which are harmful to him or others. This refers, among other things, to the whole gamut of destructive, sexual, perverse and infantile wishes which the patient had turned against or defended himself from in the course of development, but which have remained active in his current unconscious mental life (Sandler and