Indications and Contraindications for Psychoanalytic Treatment—Introduction to the Symposium1

It is necessary occasionally to take a distance from our daily work and ask: what is our work for? I recall hearing somewhere—more likely than not it was Waelder3 who said it—that an expert is one who knows everything about a subject except what it is all for. The topic of indications for psychoanalytic treatment has a very considerable heuristic value because the groundwork for a systematic consideration of it would cover a vast area of theoretical and clinical aspects of psychoanalysis. The theory of the treatment method is based on our understanding of the psychoanalytic theory of the neuroses. There should be some common understanding and agreement on what a psychoanalytic treatment is. In what kinds of situations does the use of the psychoanalytic method offer even the possibility of a change? What is the range of the psychoanalytic situation? Another most relevant consideration is the matter of the "scope" of indications for psychoanalytic treatment and the question of whether there have been changes in the neuroses and, also, whether there have been changes in the views of the psychoanalyst as he functions in the psychoanalytic situation. These areas, among others, have a definite bearing on our criteria as to what is and what is not analysable and why. Is the sky the limit with psychoanalysis as a therapy? Here we shall, I presume, have a range of answers which cover a spectrum from the theoretical ideal to the clinically justifiable.

Psychoanalytic treatment is a considerable undertaking in which the formal manifest aspects such as the recumbent position and the fundamental rule are important, but what is equally important is how crucial are the dynamic effects. In this way a psychoanalytic situation evolves and can be maintained for the psychoanalytic process. The treatment does not try to do away with inner conflict but rather tries to undo the repressions so that the entire conflict is within consciousness. In this way consciousness is enlar