Psycho-Analysis and Psychiatry1

The material studied by the psycho-analyst emanates from his patient and is biographical in kind. This material comprises as its very essence an abundance of data such as are otherwise inaccessible to investigation. The patient under examination either is unaware of these data, though they are deposited in his mind, or he is disinclined to confess them. They are brought to light, and their overwhelming significance for the scientific study of the individual clearly revealed, through the special situation designed for the patient by the analyst. In this situation, technically known as the 'analytic situation', the patient is given the opportunity of developing his confidence, his feeling of trust, to the full; he is enabled gradually to remove the mask which every individual is compelled to wear in social life, and ultimately to lift that inner mask behind which every individual keeps hidden from himself what he does not desire to know about himself. The patient accomplishes this self-unmasking by the technical means of 'free association'. His compliance with this procedure is enforced by the pressure of his sickness, by his desire for recovery. But sooner or later, inevitably, the analytic situation changes its aspect. The patient turns uncompliant; he engages in a display of varying emotions; he behaves as if pulled hither and yon by one or another acute conflict; finally one sees he has become emotionally involved with the analyst himself in some personal way. The deciphering of this surprising phenomenon called 'transference' remains Freud's greatest methodological discovery. What happens is this: The patient has been asked by the analyst to give free rein to his thoughts and feelings. He does so, and in doing so he progressively abandons the higher intellectual controls characteristic of maturity and thus revives that primitive childhood state of mind in which such controls