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A focal point of psychoanalytic therapy occurs when the interchange between analysand and analyst is blocked by resistance and the patient's associations are disrupted to ward off a hidden interfering idea. Here an appropriate analytic interpretation should restore the integrative function of the ego, bringing the hidden idea to consciousness and permitting associations to continue.
The ability of the patient to verbalize thoughts during free association is a sign rather than an ultimate test of the ego's integrative capacities, which are demonstrated pragmatically by the ability to love and work, and metapsychologically by reconciliation of the instinctual needs with the conditions in outer reality. Limitations to the effectiveness of analysis may arise from elements in the instincts, in outer reality, or in the unifying ego itself. Under the immediate stress of the treatment situation, the analysand's verbalizations, both through their form and their content, serve as cues to the total adaptive functioning. From the flow of associations, the analyst unravels the contemporary conflicts and the shaping influences of infantile fantasies. His interpretation in turn 'does not depend solely on associative material, but in addition on the circumstances of its narration, the behavior of the patient before and after analysis, together with every remark or disclosure made by the patient' (4).
As an example, during her recollection of an erotic scene, an analysand hesitated and reported that her hand had suddenly become numb. Fortified by past experience with her, the analyst made the interpretation: 'You are not only recalling the past. You are reliving it and would like to touch me now as you