Adaptation and the Psychiatrist in a World of Change

The advent of psychoanalysis as a form of therapy, research tool, and personality theory has been added to by many famous psychoanalytic pioneers. In more recent years the concept of adaptation as a process of maturation and identification has become increasingly more important in our literature. In the works of Hartmann, Loewenstein, and Kris, as well as Anna Freud, ego functions are an extension of Freud's id psychology.

The primary thrust of most psychotherapies lies in the identification and interpretation of the patient's problems, with curability related to his ego-adaptiveness and ability to resynthesize both conscious and unconscious conflict through the transference neurosis. Although the literature does talk about counter-transference as an important element in therapy, the term “adaptive” is rarely used when speaking of the psychiatrist. This may be because of the psychiatrist's unwillingness to look at this aspect of the therapy and its' subsequent outcome.

Adaptation, or growth, is expected of the patient. However, the psychiatrist too often remains tied to value systems of unconscious ideation imposed upon him during earlier phases of development and at times ceases to mature both intra-psychically and societally.

There are many forms of adaptation in the successful psychiatrist. These lead not only to his being a successful therapist, but also to having a more fulfilled personal life. I shall indicate that the patient's progress in any therapy is heavily related not only to his own ego-adaptive mechanisms but may also be more fundamentally