The Curative Factors in Psycho-Analysis1

The psycho-analytic technique is a method both of research and of therapy. The practitioner of psycho-analysis who undertakes to treat patients must never lose sight of the fact that his contractual relationship to his patients is therapeutic. We cannot and do not promise improvement or cure; but our acceptance of the patient and his fees implies our considered opinion that psycho-analysis is for him the treatment of choice. On the other hand, Freud has repeatedly stated that nothing interferes as much with the proper conduct of a psycho-analysis as what he called 'therapeutic zeal'. He stated that the primary aim of the psycho-analyst is to know, and that he should not be preoccupied with the therapeutic goal. He condemned, at least theoretically, all intervention other than interpretation, all active participation in the relationship with the patient, since such interventions are apt to blur the patient's transference and therefore interfere with the clarity of the analyst's vision and understanding.

Is there an inherent contradiction in these two attitudes—(i) that our contractual relationship with the patient is therapeutic and (ii) that the aim of the analyst is only to acquire and impart knowledge? To my mind, there is no contradiction between these attitudes, if we accept that insight is the central factor in the therapeutic process. It is with Freud's discovery of resistance, with his technique of lifting repression to render the unconscious conflicts conscious, that psycho-analytic technique historically starts. It has, of course, always been a basic tenet of psycho-analytic theory that insight is therapeutic. In recent years, however, much stress has been laid on other therapeutic factors, such as the importance of the recovery of a good object in the analyst and therefore the importance of the analyst's actual personality, the role played by the setting, and many others.

The thesis of my paper is that insight is a preconditi