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In evaluating therapeutic results, individual observation is more reliable than statistical techniques because of the difficulty in speaking of therapeutic results in general terms. Individual observation does not usually reach those who have successfully terminated treatment. Patients seen immediately after termination may show a transient recurrence of the old neurosis, with or without depression, as a protest against the separation and frustration reaction over not having been made omnipotent by the analyst and not having achieved his ego ideal. A somewhat later phenomenon is pseudoamnesia for the period of analysis, and a conscious forgetting of the content of the analysis, but with the details readily available in the preconscious, resulting from a shift of cathexis back to the external reality. Patients seen for re-analysis exhibit a striking positive and negative fausse reconnaissance that may reflect an ego limitation in the assimilative function.
Two patients seen nearly thirty years after successful termination of analysis highlight the complexities of both the analytic process and evaluation of its effect. Their recorded follow-up is rendered more significant as they have been extensively described in previous publications by the author. As is generally true for analytic therapy, the therapeutic success in both instances was dependent for its stability upon certain conditions specific for each patient. In the case of a woman with great penis envy and intellectual aspiration, continuing success in her sublimative efforts had to be maintained. In the case of a woman who was helped through analysis to find satisfaction rather than terror in her femininity, the essential condition of health was her physiologic function as a prolific woman. Analysis conquers only parts of psychogenesis; it improves the capacity to change neurotic frustration into valid compensation.