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In his various discussions of technique, Freud (1912, 1913, 1916-1917) typically attributed secondary importance to the patient's intellectual interest as a factor motivating the movement toward cure in psychoanalytic treatment. While acknowledging the therapeutic usefulness of such interest (“In the course of the treatment yet another helpful factor is aroused … the patient's intellectual interest and understanding” [1913, p. 143]), Freud consistently maintained that overcoming the resistances required “new sources of strength for which the patient is indebted to his analyst … [and which are] reducible to transference and instruction” (1913, p. 143). “What turns the scale in [the patient's] struggle,” he observed in 1916, “is not his intellectual insight—which is neither strong enough nor free enough for such achievement—but simply and solely his relation to the doctor” (1916-1917, p. 445).
Despite Freud's instructive qualifiers about the relation of intellectual interest to psychoanalytic cure, such interest has long been recognized as a necessary constituent of the curative process. Freud himself testified to this state of affairs when he made the very existence of a transference neurosis hinge on a therapeutic alliance that betokened the patient's ability to comply with “the necessary conditions of the analysis” (Freud, 1914, p. 154; c.f. Kanzer, 1975, p. 52). Such compliance, of course, presumes a measure of insight into the rationale of psychoanalytic treatment, and the resolution of the transference neurosis via interpretation cannot be accomplished in patients who lack this requisite capacity for insight. Such patients—certainly those with significant organic pathology—are simply nonanalyzable.