The Curative Factors in Psycho-Analysis—Contributions to Discussion1

Dr Gitelson has presented us with a paper so rich in content that it is impossible for the opener of the discussion to talk about all the problems with which it deals. It is for that reason that I want to limit myself to some points which seem to me of great interest. Discussion is impossible without a certain difference of opinion, and if my own ideas are in some respects divergent from Gitelson's that does not preclude my high estimation of his paper as a whole.

One idea is present throughout Gitelson's paper, either explicitly or in the background, viz., that without a close emotional relation between analyst and patient psycho-analytical treatment cannot be effective. He points out that so-called humanistic trends in psycho-analysis are represented as newly discovered 'curative factors' and that the proponents of this view ignore the fact that the dynamics of their operation are identifiable in the classical analytic situation and intrinsic to it. Representatives of various forms of neo-analysis have no right to reproach us that the psycho-analytic attitude is an impersonal one. About this there is not the least difference of opinion between us, and I am very glad Gitelson emphasized this. But I do not know if I agree with his elaboration of the point in relation to the psycho-analytic situation as he considered it. Gitelson gives as his opinion that in the beginning of psychoanalytic treatment the following process develops: 'Even as the first external objects receive the primitive narcissistic transference, so does the analyst in the first phase of analysis evoke the narcissistically regressed libido of the patient.'

The word narcissistic can lead to confusion, as van der Waals made clear in his article about the problems of narcissism.2 Gitelson is speaking, it seems to me, about early object relations, i.e. about the preoedipal phase of development. Do the needs of the patient rooted in this phase of development determine