Developments in the Psychoanalytic Conception and Treatment of the Neuroses

During the past few years we have witnessed rapid progress in general medicine culminating in the recent advances in the chemotherapy of infectious diseases. In view of this bright picture in our neighbor's field it is fitting to ask ourselves whether we too are in a position to report improvements. The purpose of my paper is to show that we are, although in our field developments have been slower and less spectacular.

Although mental healing is the oldest kind of healing, scientific psychotherapy is a very young branch of medicine. It was only some forty years ago that Freud laid its foundations by the discovery of a method for the penetrating psychological investigation of mental life. The essence of this method was, and still is, to maintain a special kind of psychological contact with the patient over an extended period and by certain technical means enable him to unfold himself mentally before the eyes of the physician. This procedure of prolonged observation however was more than a method of investigation. It appeared itself to have a therapeutic effect which could be directed and intensified by skilful influence. In medical practice it has been employed ever since that time for its value as a means of treatment.

Freud summed up the early results of his psychoanalytic studies in two closely interrelated formulations based on the hypothesis of instinctual drives. According to the first formulation, neurotic symptoms are due to the repression of instinctual drives during the period of childhood; the drives thus repressed are excluded from normal development yet they