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In his first chapter Michael Balint reviews changes made by Freud in his formulation of therapeutic techniques and aims in psychoanalysis. In an initial period Freud strove to make the 'unconscious conscious', to overcome the patient's 'resistance' mainly by persuasion, and to remove his 'infantile amnesia' leading to the uncovering of the Oedipus complex. This period the author calls that dominated by a dynamic orientation. Its emphasis was on the id, and content analysis was in the foreground. The next approach was the topical one. The neurotic symptom was seen as a compromise between the id, ego, and superego. Freud formulated 'where id was ego shall be'. The emphasis lay on helping the patient to give up costly defense mechanisms and adopt new ones of greater economic value.
Balint holds both formulations limited inasmuch as they take only the individual into consideration. He calls this limitation the 'physiological or biological bias'.
The second chapter holds that a new orientation took place with the observation of 'formal elements'—the observation of the patient's behavior in the analytic situation. This is intimately linked to the patient's character and these formal elements are part and parcel of the 'transference', i.e., an object relationship. The author maintains our technique is now ahead of our theory: we know fairly well how to deal with complicated problems of object-related attitudes or emotions, but are unable to describe them adequately or label them in our diagnostic statements.
The third chapter tries to explain the historical reasons for this difficulty. Freud based his psychological theories on his clinical experiences with obsessional neurotics and his studies on melancholia. Mrs. Klein followed him in the latter. The common quality of these pathological forms is their 'withdrawal from objects'. Hence the lack of a consideration of object relationships in the theory. The 'physiological or biological bias' should be supplemente