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Once upon a time when analysts considered the mechanism of the therapeutic action of psychoanalysis, it was at a level of theoretical detail that has almost vanished from our discourse. While Freud did not discuss therapeutic action directly (as Aisenstein notes in this supplemental issue of The Psychoanalytic Quarterly), one can infer its mechanism at the most detailed level in his earliest theoretical model, derived from his study on aphasia and elaborated in his essay on “The Unconscious”:
The system Ucs. contains the thing-cathexes of the objects, the first and true object-cathexes; the system Pcs. comes about by this thing-presentation being hypercathected through being linked with the word-presentations corresponding to it. It is these hypercathexes, we may suppose, that bring about a higher psychical organization and make it possible for the primary process to be succeeded by the secondary process which is dominant in the Pcs. Now, too, we are in a position to state precisely what it is that repression denies to the rejected presentation in the transference neuroses: what it denies to the presentation is translation into words which shall remain attached to the object. A presentation which is not put into words, or a psychical act which is not hypercathected, remains thereafter in the Ucs. in a state of repression. [Freud 1915, pp. 201-202]