Meeting of the Psychoanalytic Association of New York

March 19, 1962. DEFINITIONS OF PSYCHOTHERAPY. Sidney Tarachow, M.D.

Both analyst and patient must set aside their need for each other as real objects so that analysis may take place. This central idea is discussed by Dr. Tarachow and placed within a larger framework which might serve as an overall conceptualization of psychotherapeutic techniques as well as a concept of psychoanalysis. The patient's neurosis, as well as the normal ego structure, is a barrier which he has erected against the expression of his infantile urges. Keeping in mind that the symptoms and compromises are ego-syntonic, we see the purpose of therapy as the removal of those barriers which impair functioning and happiness and cause mental pain. In deciding what form of treatment to offer the patient we must assess the nature of his defenses, the strength of his ego, his tolerance to insight, and his current reality situation. The transference is also a factor in deciding whether the patient can tolerate psychoanalysis or psychotherapy.

Dr. Tarachow defines the treatment choice in explicit terms. Psychoanalysis is that treatment in which the transference, repression, ego defenses, and resistances are all freely subjected to analysis and resolved as far as may be required by dealing with the infantile intrapsychic conflict and the derivative symptoms. Psychotherapy is a selective, limited treatment in which a rearrangement rather than a resolution of these elements is the goal. All forms of psychotherapy should be conceptualized in psychoanalytic terms.

The author offers three principles of psychotherapy within which all psychotherapeutic techniques should be comprehensible. 1. Supply the infantile object in reality, i.e., the unanalyzed transference. 2. Supply displacements, i.e., new symptoms and/or resistances. 3. Supply stability, i.e., ego or superego building, education, or real events. In analysis the analyst rejects the patient and teaches the patient to reject him; problems are