Working Through

PSYCHOANALYSIS IS AN INTENSIVE LONG TERM treatment designed to produce profound changes in a person's character. The treatment time is three or more years; the frequency of sessions is three or more per week. The question as to what makes such intensive and extensive treatment necessary, brings the reply that the time is needed for the "working through." The meaning of this term coined by Freud (1914) has changed over time and today each school of psychoanalysis uses the term with different meanings. These in turn reflect different ways of conceptualizing and practicing psychoanalysis.

From an interpersonal perspective working through is the collaborative process of changing the many interlocking, relatively autonomous facets of a person's character. This is expressed in practice through a series of steps. During the initial interviews the analyst develops an overview of the patient. He shares part or all of his formulations with the patient, and they agree to begin working on a problem that seems relevant to both of them. The interpersonal analyst encourages an attitude of collaboration from the inception of treatment. As they work on understanding and changing one facet of the patient's character, it becomes clear that another facet is interlocked with the first. This new facet also receives focus and attention, and it in turn will lead to other interlocking facets. It is not possible to change only one or two facets of this chain. The entire chain must change in order for the patient's experience of living to become significantly improved.

In the Freudian and Object Relations systems all these facets will be reduced to expressions of various instincts or defenses against these instincts. In those systems character is completely defined by these two ingredients.

From the interpersonal perspective each facet is not prejudged to be something else, nor is it automatically reduced to instinct or defense. The interpersonal position regards character as multi