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Various dynamic factors enter into different types of psychotherapy, as viewed from the perspective of psychoanalytic psychology. The psychiatrist should evaluate the procedure he employs and bear in mind the difference between therapies aimed at symptoms and therapies aimed at causes. If the treatment is a symptomatic one, he should know why and how a symptom has disappeared or is transformed into another dynamic expression of emotional forces.
Kaufman gives a brief, very clear and good review of the most important principles of psychoanalysis with particular emphasis on the transference and attempts to explain the dynamics of various psychotherapies from this point of view. Hospitalization may give excited or depressed patients immediate relief from symptoms. Removal from the demands of life relieve the patient of the psychic tensions thereof. Occupational therapy permits sublimated gratification of repressed impulses.
One set of psychotherapeutic techniques has the purpose of allaying anxiety. Hypnosis, reassurance, direct and indirect suggestion, removing environmental stresses and other forms of authoritative intervention, attempts to interest the patient in work and social activity and to distract him from his symptoms, fall into this category. The therapist assists the patient in repressing. A compliant transference enables the patient to accept reassurance partly because of the authority of the physician, partly because there is a decrease of guilt and anxiety.
The second category of therapeutic techniques is the one directed toward uncovering and removing causes and enables the patient to understand his unconscious conflicts and find new solutions, either by direct advice or by increasing his ability to tolerate conflict at a conscious level. Psychoses are