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The Curative Factors in Psychoanalysis.
I.The First Phase of Psychoanalysis. Maxwell Gitelson. Pp. 194-205.
II.Sacha Nacht. Pp. 206-211.
III.Hanna Segal. Pp. 212-217.
Contributions to Discussion. Pp. 218-234.
Gitelson discusses the theoretical curative factors already operating at the beginning of analysis. The 'more or less good' mother-child situation is the model for the relationship with the analyst with its potentialities for health. Under normal conditions, spontaneous tendencies of the libido to move from deep narcissistic attachments toward investment of external and internal objects are given an element of structure and an opportunity for ego change in a transference relationship. The analyst, by his own ego-controlled regression, achieves a diatrophic attitude, acting like a good mother in fostering the drives which permit ego development and progression. Rather than becoming a good object or suggesting 'growth' to the patient, the analyst operates as an auxiliary to the patient's ego with its own intrinsic potentiality for reality-testing synthesis and adaptation.
Nacht discusses the 'humane relation in the transference'. He feels, with Glover, that therapeutic effect must be credited not to interpretation alone, but in combination with other factors, and that the common denominator of the curative factors resides in the person of the analyst. What the analyst is rather than what he says is important.
Segal returns to the point that insight is a precondition for any lasting personality change and that all other subjects are related to it. She defines psychoanalytic insight as the acquisition of knowledge about one's unconscious through experiencing consciously and, in most cases, being able to acknowledge explicitly and verbally, hitherto unconscious processes. She feels that such insight can be experienced only in the transference relationship and credits Melanie Klein with expanding the concept of the transference. Insight is therapeutic because