The Curative Factors in Psycho-Analysis

I

This is not a paper on technique. It is an attempt to look theoretically at the characteristics and qualities of the first phase of psycho-analysis, before its explicit method of treatment—systematic interpretation—can come into play. The paper concerns itself with what the author considers to be the largely non-verbal givens which operate in the initiation of the psycho-analytic process. These are 'necessary but by themselves not sufficient precursor conditions for the establishment of an effective psycho-analytic situation'.3 As such they are basic to any psychotherapeutic effort, but in psycho-analysis they are contingent on particular technical manoeuvres and structural orientation. Though the paper will not be concerned with their discussion, it must not be assumed that the author discounts the importance of the experientially and intellectually determined 'function of a diagnostic-perceptive nature' with which we 'incessantly screen every detail which the patient offers to our attention, differentiating them via our total background [of knowledge] and experience' and adjusting our therapeutic attitudes 'in reaction to specific presenting problems with their multitude of neurotic configurations'.4 But these are aspects of clinical psycho-analysis which are richly documented in the literature, while I have chosen to focus on that aspect of the problem of which, despite its ubiquity, that cannot be said. By and large, analysts have taken for granted that aspect of their therapeutic task of which, in 1913, Freud (6) spoke as follows:

It remains the first aim of the treatment to attach (the patient) to it and to the person of the doctor. To ensure this nothing need be done but to give him time. If one exhibits a serious interest in him, clears away the resistances that crop up at the beginning and avoids making certain mistakes, he will of himself form such an attachment and link the doctor up with one of the imagos of