Analysis Terminable and Interminable

Experience has taught us that psycho-analytic therapy—the liberation of a human being from his neurotic symptoms, inhibitions and abnormalities of character—is a lengthy business. Hence, from the very beginning, attempts have been made to shorten the course of analysis. Such endeavours required no justification: they could claim to be prompted by the strongest considerations alike of reason and expediency. But it may be that there lurked in them some trace of the impatient contempt with which the medical profession of an earlier day regarded the neuroses, seeing in them the unnecessary results of invisible lesions. If you were obliged to deal with them, you simply aimed at getting rid of them with the utmost despatch. Basing his procedure on the theory formulated in Das Trauma der Geburt (1924) Otto Rank made a particularly determined attempt to shorten analysis. He assumed that the cardinal source of neurosis was the experience of birth, on the ground of the possibility that the infant's 'primal fixation' to the mother might not be surmounted but persist in the form of 'primal repression'. His hope was that, if this primal trauma were overcome by analysis, the whole neurosis would clear up, so that this one small piece of analytic work, for which a few months should suffice, would do away with the necessity for all the rest. Rank's argument was certainly bold and ingenious but it did not stand the test of critical examination. Moreover, it was a premature attempt, conceived under the stress of the contrast between the post-War misery of Europe and the 'prosperity' of America, and designed to accelerate the tempo of analytic therapy to suit the rush of American life. We have heard little of the clinical results of Rank's plan. Probably