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The Indications for Psychoanalysis. Edward Glover. Pp. 393-401.
In order to discuss indications for psychoanalytic treatment, it is necessary to achieve some agreement on the nature of psychoanalytic therapy and the diagnosis and prognosis of mental disorders.
To be able to call one's therapy psychoanalytic, one must: 1, adhere to the fundamental concepts of the unconscious, unconscious conflict, repression, infantile sexuality, and transference; 2, understand the processes of mental development by which they are arrived at; 3, have endeavored via personal analysis to eliminate the errors of subjective bias; 4, have learned to apply the techniques of free association and interpretation; 5, be capable of analyzing the transferences and countertransferences arising in the therapeutic situation. The significant distinction between psychoanalysis and other forms of psychotherapy lies in the capacity and determination to analyze the transference.
Diagnostic classifications based on development permit the ordering of adult mental disorders in accordance with the level of fixation to which the mind regresses when faced with frustration or traumatic excitation. Symptom-formations, character disorders, and psychosexual difficulties can be arranged in roughly parallel series, and rough equivalences are established between the three groups. This type of classification is of significance for therapy for it shows prognosis in terms of degree of ego disorder and transference potential or accessibility. In general, the earlier the fixation points, the greater the degree of ego disorder and the less the accessibility.
Three factors must be considered in prognosis: 1, the depth of symptom-formations, in which constitutional, developmental, and precipitating elements are assessed; 2, the degree of transference potential (primary gain); 3, the strength and persistence of precipitating factors which determine the strength of secondary gain. Where no major symptom-formations are pr