Memory and Therapeutic Action

The aims of psychoanalysis have been greatly elaborated over the hundred years since Freud's original model of undoing repression and recovering memory into consciousness (see for example Sandler & Dreher, 1997). But these advances have not brought with them an updating of the role of memory in the therapeutic process, nor a clear and consistent theory of therapeutic effect. Some still appear to believe that the recovery of memory is part of the therapeutic action of the treatment. There is no evidence for this and in my view to cling to this idea is damaging to the field.

While no one nowadays would explicitly espouse Freud's earliest model (Breuer & Freud, 1895), its legacy is clear in later models of therapeutic change, including Freud's own (1914).1 Greenacre, for example, expresses concern that the repetitive confrontation and interpretation of drive and defence as manifested in current life including the transference could lead to a neglect of the exploration and reconstruction of early memories and an ignoring of the need to ‘work to’ traumatic recollections (1956, pp. 644-5). Notwithstanding Kris's (1956) revolutionary reformulation of the psychoanalytic understanding of memory, the majority of ego-psychologists have continued to place emphasis on the therapeutic efficacy of reconstruction for a variety of clinical (Blum, 1980; Rosen, 1955; Sachs, 1967) and theoretical reasons (Schimek, 1977, 1987). Nor has the modern emphasis on the therapeutic relationship as the primary motor of therapeutic action, for which we are indebted to Winnicott (1956) and Loewald (1960), succeeded in eliminating the emphasis on the recovery of childhood experiences.

It is commonly argued that it is the ‘presence’ of the analyst as he experiences the past that leads to the change of meaning and the reorganisation and re-evaluation of early experience (see, for example, Viederman, 1994). Doubts about the accuracy of early memories have prompted some theoreticians to deemphasise the r