25 October 1959: Truth - Need For, and Need to Keep Maladjustment in Repair. Cogitations

Psychoanalytic procedure pre-supposes that the welfare of the patient demands a constant supply of truth as inevitably as his physical survival demands food. It further presupposes that discovery of the truth about himself is a precondition of an ability to learn the truth, or at least to seek it in his relationship with himself and others. It is supposed at first that he cannot discover the truth about himself without assistance from the analyst and others.

It is likely that this belief has an empirical foundation in that all are familiar with the fact, probably learned very early in life, that a mistaken idea leads to mistaken action, which leads to frustration and other forms of suffering. But a true view can do the same, and on the choice that is made depends the nature of the suffering experienced. The choice is really a choice of method; the essential difference for our purposes in the nature of the choice made is that one is in favour of the method of frustration evasion, and the other in favour of the method of frustration modification. Freud's pleasure principle would seem to tend in the direction of frustration evasion, his reality principle in the direction (in his view) of frustration modification. But in fact, as Freud saw, the impulse to pleasure is not absent under the domination of the reality principle, nor is the reality principle absent under the dominance of the pleasure principle. Much depends on the fact that the choice is influenced by what is, and what is conceived to be, the reality when the choice is made. But the decision is seriously affected by the individual ability or inability to tolerate enduring frustration. If the patient is unable to endure frustration – that is, frustration over a period of time – he will lean towards the methods of frustration evasion.

Whichever choice is made, work has to be done – a point that may escape the attention of the patient, and of those on whom he depends in the most severe cases of all, namely psychot