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The first question is for Dr. Horowitz: “If people's unconscious fantasies endure for their whole lives, how do people change or how does analysis change people?”
The question is analogous to asking “How does anybody grow up?” The issue, I think, is not whether anyone's unconscious fantasies change. That is, it is not whether one has a set of wishes or fears or fantasies that change in the sense that they become incorporated in some increasingly organized form as unconscious fantasies. The question is whether in the course of development some aspects of the transformations of those fantasies can lead to some change of function in the person—or, on the other hand, do these original ideas or wishes lead to unmodifiable developmental distortions? I think the issue of change has nothing to do with whether or not we had some early wishes. The problem that comes up, for me at least, about the nature of therapeutic action in analysis, is that from the very beginning of psychoanalytic history, “change” was connected with a set of fantastic assumptions that there would need to be some kind of explosive discharge—the big bang concept of the origin of the universe. For in fact the first ideas about neurosogenesis were something like the big bang concept of origin—which was then to be followed by a big bang concept of cure. The cure would take place through explosive abreaction and the recapture of the memory of what was then considered to be the repressed big bang experience. This is something that is