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Up to this point we have determined how psychoanalysis operates in principle: it demonstrates derivatives of the unconscious as such, and thereby induces a tolerance of the derivatives which become less and less distorted. Gradually it confronts the ego with contents previously warded off and abolishes the division between these isolated contents and the personality as a whole. It allows the warded off instincts to catch up with the development which the ego has passed through in the meantime, changing infantile into adult sexuality, and thus makes possible a well regulated sexual economy. It leads to 'condemnations' of certain instinctual satisfactions by the reasonable ego and, finally, to sublimations. Everything else is incidental.
What are the practical details of this process? What happens after a patient lies on the couch? Here I am tempted to make a digression and to ask another question: should the patient lie down at all? I believe we will do well to yield to such temptations to digress. The advantages of the usual position of the patient, recommended by Freud,26 are clear: it allows the patient relative relaxation, and makes it easier for him to say unpleasant things because he does not face the analyst; and the analyst himself is saved the discomfort of having to