Three Ways of Failure and Analysis

WE ARE each familiar with the failure of certain kinds of cases in analysis. Particularly difficult and unresponsive to successful therapy are people with styles of life in which homosexuality, alcoholism, or chronic depression are the major presenting ‘problems’. To these can be added those with paranoid obsessions, the severe so-called character neuroses and people who have been diagnosed as sociopaths and psychopaths. That so many and so varied kinds of cases for which analysis may have been considered the preferred method of treatment turn out to be failures, gives cause for considering analysis afresh and in the light of these failures.

We are also familiar with another sort of failed cases, those in which a morbid cancer develops during the analysis, or which end in suicide, or where the counter-transference reactions constellate such exorbitant fantasy and massive affect, or psychopathological lacunae, in the analyst that the case must be transferred or the analysis abandoned. Smaller failures perhaps go unrecognized—analyses that have as by-products estrangements within families, loss of extraverted adaptation, splintered friendships.

Through clinical reflection upon these various sorts of failures we may examine the kinds of cases which fail, or for which analysis fails, and we may bring our own failures as analysts to other analysts for scrutiny—all of which reflection attempts to correct present failures and minimize future ones. This manner of clinically reflecting is a function of the dominant empirical and moral theme of our culture: learning through mistakes, trial and error, getting better through working at it, if at first you don't succeed try, try again, in which the model is one of improvement away from mistakes, error, and failure, towards competence.

Failure in this metaphor is linked in a polarity with success, and we tend to measure failures normatively, that is as a privation of success. Failure is the obverse of successfu