'Active' Psycho-Analytical Technique and the will to Recovery1

You know the complexity of the problems with which we are confronted in certain cases that come to us for treatment and how often we are tempted to fill up with premature improvisations the gap that often separates theory from reality. Freud formulated these problems at the Fifth International Psycho-Analytical Congress in Budapest, in 1918, in the following manner: 'Ought we to leave entirely to the patient the task of dealing with the resistances that we have brought to light in him? Is it not possible to give him help other than that coming from the psycho-analytic transference? Should we not help him by placing him in the psychic situation most favourable for resolving the conflict? The reactions of patients depend just as much on external circumstances. Ought we to have any doubts about altering these circumstances in a manner that will effect the end we seek?' And Freud replies: 'I think I can say that such an active intervention on the part of the analyst is blameless and quite justifiable.'

You know how these considerations have become—so to speak—the starting-point of discussions on the active or passive psycho-analytic treatment; how in the course of these discussions Ferenczi generously tried—not, I think, without difficulty—to give us the benefit of his personal experience. You know also that Rank suggested some radical solutions for certain difficulties in treatment, based on his seductive theory of the trauma of birth, which to-day we believe to be an exaggerated and dangerous generalisation for any who are not familiar with the real aspects of the problem. Experience teaches us that with our current conceptions we can develop only slowly and carefully. The conclusions acquired in the course of treatment of certain patients cannot always be generalized and indiscriminately applied to all patients. According to their conditions of life they may often react quite differently from each other.

Now what are the principles that should urge us apart