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Playing back to the patient, by means of tape recordings, important parts of therapy sessions has proved valuable in treatment. The procedure consists of insuring extended and repeated reaction by the patient to his own verbal cues ('autopsychic driving') or cues verbalized by the therapist, but based on the patient's psychodynamics ('heteropsychic driving'). Since this compels a continued response within a field largely limited by the cue material, it has been termed 'psychic driving'. Selection of a satisfactory key statement for psychic driving requires awareness of the patient's major problems. Autopsychic driving has as its primary value the penetration of defenses, elicitation of hitherto inaccessible material, and the setting up of a dynamic implant. Its purpose is usually achieved within thirty minutes of driving. Heteropsychic driving is best carried on over extended periods (ten to twelve hours daily in hospitalized patients or during sleep). Its primary uses are changing of attitudes and setting up a dynamic implant.
Psychic driving has been used in many ways: with pillow and ceiling microphones, presentation of the same theme in different ways, isolation of patient, etc. Purely mechanical variations seem of little importance. The responses to psychic driving include immediately constructive reactions, partial blocking, rejection and later acceptance, and rejection and escape, among others. By this method, the patient is shielded from the full implication of his own verbal communications. The voice sounds different. One's own voice is heard ordinarily as a synthesis of air and tissue conduction. Defense against hearing what one does not wish to hear is organized against the synthesis of tissue and air conduction. In psychic driving, tissue conduction is eliminated and thus there is a new situation against which defenses have not been organized. This breakdown in the shielding occasioned by elimination of tissue conduction is one of the basi