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In a very condensed and compact paper, Knight attempts to evaluate psychotherapeutic methods and practices. Since he believes that no single technique, approach, or method is good for all patients, he attempts to isolate the basic principles of all good psychotherapy. In his opinion few patients coming for psychotherapy are suitable for classical psychoanalysis but all of them are entitled to the kind of dynamic assessment which only psychoanalytic knowledge provides.
Knight describes the fundamental equipment of any competent psychotherapist. Then he discusses briefly a comprehensive apprisal of the patient and a setting of tentaive goals. In the planning of the therapeutic campaign he stresses the importance of assessing the impulse-control balance in the given patient. If this impulse-control balance is judged to be precarious, then the patient is not a candidate for exploratory techniques. If, on the other hand, the appraisal indicates that the patient, though distressed and symptom plagued, is maintaining strong defensive lines against further decompensation, then the therapist will feel safe in further testing the patient's defenses through exploration.
Knight then designates two fundamental kinds of psychotherapeutic measures. The primarily supportive measures are intended to reconstruct the defense mechanisms and adaptive methods of the patient. The primarily exploratory measures have the aim of systematically investigating the defenses and those factors responsible for the origin of the defenses. Psychoanalysis offers the best method available to achieve the more ambitious goals of fundamental alteration of character structure, with the eradication of neurotic mechanisms. In skilled hands it can be applied with appropriate modifications to the perversions, incipient schizophrenias, depressions, etc. In doing exploratory psychotherapy, the three main elements which have to be taken into account are the unconscious content, the transference, and the