Reider discusses, with examples, the elements of various types of brief therapy using psychoanalytic insight. Effective improvement accomplished in only a few interviews is usually brought about by replacement of distressing symptoms by unrecognizable or less distressing symptoms, with no change in the personality structure or defense mechanisms. This is made possible when certain needs of the patient have been met. The same replacement of disturbing symptoms by other

less distressing ones is operative in spontaneous improvements or 'recoveries', and is comparable to certain everyday activities which many of us use to discharge tension or strengthen defenses (such as buying a hat to get over depressed feelings), especially when this activity or other factors strengthen the ego and permit realignment of the conflictual forces. In Reider's clinical examples, insight and understanding of the transference were not necessary for the restoration of psychic equilibrium.