The Curative Factors in Psycho-Analysis—Contributions to Discussion1

There are some themes in psycho-analysis which it is not possible to delineate and discuss with any feeling of satisfaction that we have encompassed their most important aspects and have achieved some form of gestalt in our presentation. It seems to me that 'The Curative Factors in Psycho-Analysis' falls into this category. Nevertheless, the topic raises such vital issues that it is well worth discussing periodically, and re-evaluating the hypotheses on which we base our work.

While the speakers have selected different aspects of this theme, they all appear to recognize the central importance of the fact that it is in the quality of the analytic situation that 'cure' resides. This 'quality' they all relate to the attitude of the analyst to his relationship with his patient. Where they differ is in their definition of what this attitude should be.

I find myself basically in agreement with the approaches of Gitelson and Segal on this point, and in disagreement with many of the formulations of Nacht. I must, however, express my gratitude to Nacht, whose paper provoked me to re-think some of my own ideas on this subject.

It seems to me that psycho-analytical theory and technique is based on the hypothesis that man has within himself the prerequisites for a healthy, happy, object-related existence. We assume that there is a life-promoting force that operates not only biologically but intra-psychically in each individual, which, given reasonably stable and good maturational and environmental conditions, will be stronger than any disintegrative forces at work. In about 1520, in his Liber de generatione Hominis, Paracelsus expressed the same idea. He postulated that when the activity of the life principle (the Archaeus) takes place in a normal and regular way, unimpeded by any obstacle, the result is health. If it is impeded by any obstacle or if it acts abnormally, the result is disease. Psycho-analytic technique is therefore, as Rickman put