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FROM THE MOMENT of its invention, the psychoanalytic method thrilled Freud and his followers. In one stroke, it seemed, Freud had given us a technique that promised radical therapeutic results for previously untreatable illnesses, and that also offered a scientific approach to exploring the human soul. As time went on, however, questions arose about the power of the method to cure. When indications for analysis were broadened so that not only the symptom neuroses but also the character disorders were treated, the very concept of cure became increasingly vague. Eventually, even claims that symptoms could be permanently abolished seemed infused by wishful thinking. Freud himself became a therapeutic pessimist.
Despite these developments, everybody could see that something happens in the consulting room that grips the human imagination. In the course of analyzing his patients, Freud evolved a vision of human nature so compelling that it shaped the intellectual life of an entire century. Admiring science and disdaining philosophy, Freud insisted that we had his method to thank for what we had learned; anybody who followed the correct procedure would arrive at the same discoveries he did. So psychoanalysts are left with a paradox: Our method outshines our results, which can be ephemeral, even ineffable. The effects of analysis are notoriously difficult to quantify, to demonstrate convincingly, or to compare with the reports of therapists using more pedestrian techniques. Our special claim lies less in what we do than in how we do it. We have idealized our method.
One result of this is that psychoanalysts—perhaps uniquely among therapeutic specialists—often evaluate treatment not so much by its outcome as by our judgment of how it was conducted. If we do not like the technique, we disqualify the result. The very vagueness of our concept of