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In one of his technical papers, Freud (1912) tells of a therapeutic experiment. He told a patient (a young woman) about a repressed homosexual experience of which the girl's mother had informed him. The patient went into a convulsion each time Freud mentioned this incident. She finally 'simulated imbecility and total loss of memory' to defend herself against what Freud had told her.
This experiment illustrates a fact that we all know but sometimes forget about psycho-analytic therapy. We know that the deep unconscious is not directly accessible to therapeutic influence. The direct impact of the therapy is at the level of the system preconscious. We influence the unconscious only indirectly and very slowly through the medium of its preconscious derivatives.
In the course of a psycho-analytic treatment, patterns from the past are repeated over and over again. When our attention is focused on the past, nothing seems to change. What changes from week to week is much closer to the surface. Consequently, if we wish to understand the therapeutic process, we must follow very strictly Freud's advice to 'analyse from the surface downwards'. We must focus our attention first on what is happening in the system preconscious.
Traditionally, when we analyse the patient's orientation towards present reality, we concentrate our interest chiefly on his resistances. Sometimes we take his therapeutic incentive for granted. We may even lose sight of the motives that keep him coming to the treatment in spite of his resistances.
This leads us to our most important thesis in this paper. This is that the therapeutic incentive which makes successful therapy possible must have its basis in the patient's latent and successively emerging hopes of finding a solution for his conflicts. This thesis is based on a more general one—that hopes play a centrally important part in the motivation and integration of all rational behaviour. They are the central core of the ego's integrative fu