The Curative Factors in Psycho-Analysis—Contributions to Discussion1

I cannot possibly repeat the discussion I was engaged in this afternoon in which I had the feeling that many of the admittedly obscure points in my presentation were clarified. However, I want to emphasize again that I was not discussing problems of technique. I have considered only the problem of what may be going on within the patient which is curative. That is what we are concerned with.

In my paper I stated that it was my impression that analysts seem to take it for granted that the crux of psycho-analytic cure is interpretation, insight, and the repercussions of insight. As Waelder validly suggested, the latter results in increased communication between the intrapsychic systems and within them. This is what makes what we call insight meaningful. However, it seems necessary to iterate that 'insight' as such has no therapeutic effect. I think we have all had the experience of patients who go away with much 'insight' and no therapeutic result whatever.

Now in my presentation I was taking one segment of the analytic process into consideration—the beginning of analysis. I was exploring what it could be that is already curatively oriented and operating when the patient comes to us, and during the early development of the psycho-analytic situation. I discussed this in terms of rapport and the readiness for transference, the consequent movement towards the therapeutic alliance, and thus towards the establishment of the technical situation which we call the transference neurosis. I attempted to demonstrate and to discuss factors of which the analyst must be cognizant and to which he must respond in his technique, if the function of the first phase of psycho-analytic treatment is to be successful. That function is the making possible of the establishment of the transference neurosis and the preparation of the patient for interpretation, insight, and the ramifications of insight in the terms of Waelder's comments.

There is one other p