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If you want the doctor's help you must reveal the wound.
—Boethius, 1969
THIS PAPER ADDRESSES SOME ASPECTS of the question, how psychoanalysis may be therapeutic. It begins with excerpts from a session in which disturbingly vivid dreams were reported by and discussed with the patient. It concludes with a brief consideration of the nature of the remedial effects of psychoanalytic work.
My discussion applies basically to situations where the patient can cooperate in the endeavor. This point seems worth mentioning, to introduce a measure of balance. Many, perhaps most claimed advances in analytic theory stress the role of the analyst in modifying understanding (insight) or technical approach (empathy), even when the advance is characterized as interpersonal, implying emphasis on the presence of and interaction with the other person. The accent falls on the value of the analyst's recognizing affirmative possibilities in phenomena previously seen as obstacles to analysis, such as resistance and countertransference. Part of my emphasis in this discussion is on the role of the patient's aim, participation, and responsibility in the process. This could supplement and also balance the prevalent, often one-sided, emphasis on traumatization and victimhood.
It may be useful to reflect on whether we regard analysis as meant primarily to inflame the sense of hurt and outrage that are often awakened during the work, or as meant to help face and master, where possible, and, where not, to come to terms with, the consequences of injury and personal limitations.