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There is now more than at any other time in the history of psychoanalysis a greater diversity of theories of cure and, indeed, in underlying conceptions of the nature and aims of the psychoanalytic process. But while theories of cure certainly provide the (often unrecognized) backdrop for the management of process in analysis, theories themselves are not the curative element; they must be translated into systems for understanding and programs for action in the psychoanalytic situation. The ultimate arbiter of any theoretical orientation is the effectiveness and appropriateness of its translation into a qualitatively meaningful curative environment, that is, into a clinical process that achieves a “curative” goal. In this paper, I will briefly review selected literature and then present two clinical vignettes that illustrate moments in the establishment of a curative process.
In Friedman's (1978) discussion of “Trends in the Psychoanalytic Theory of Treatment,” he notes that Freud (1913, 1914, 1919, 1926, 1937) considered three broad areas in the achievement of benefits in treatment: understanding, attachment, and integration. Much of the history of the debate on the “healing” or curative process involves the relative emphasis placed on one or another of these aspects. For Freud (1914), remembering, rather than repeating, was the fundamental goal, and in this service the patient “must find the courage to direct his attention to the phenomena of his illness” (p. 152). There must be