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WHEN WE SEE A PATIENT, it is often helpful to have some notion as to the fantasy with which he approaches us, which structures his expectations and, often, the results of our treatment. So too, I thought that it might be interesting for you to hear the fantasy with which I approach my talk on this panel.
My fantasy begins next week. I see someone in consultation who tells me that he saw a brochure describing this program on "What Cures?" and, since he was interested in cure, he thought that he would seek out the panelists for help. He had done just that and, in fact, I was the fourth consultant he had seen that week.
The first consultant suggested that he really needed to understand the developmental psychodynamics of his neurotic process, and added that an understanding of his dominant unconscious fantasy that stemmed from the second to sixth years of his life might not help unless it was also accompanied by an understanding of his earlier years as well. The former would help him to understand his neurotic patterns of adaptation, while the latter would clarify the issues that led him to cling to those neurotic patterns so tenaciously.
My patient thanked his first consultant and went on to a second who, after hearing his story, said "Your problem seems to have begun in the social environment of your early development, and you are now preoccupied with a defensive retreat into imagination and fantasy that is dominating your existence. You need a treatment that will help you to turn away from those fantasies and