You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Theories of therapeutic action are shaped by underlying conceptions of the aims or goals of treatment, and aims, in turn, reflect both explicit and implicit beliefs about what is possible in human relatedness and how it is most desirable to live. Such beliefs are values. They are statements about what is important in life. While it is not often recognized, then, theories of therapeutic action are not only laden with values, but actually assert them.
It goes without saying that no psychoanalyst sets out to decide questions of values for patients. The analysand's autonomy has always been paramount. But theories of change are rooted in values, whether we like it or not. The way a particular analyst thinks and works nudges the patient toward living in one way and not another. There is nothing wrong with that. It is simply a fact, inevitable and, therefore, unreasonable to condemn. And so, while psychoanalysts will and should struggle not to decide questions for patients, they frequently cannot avoid favoring one side of the patient's conflicts over others. The scale will be tipped one way or the other, ceaselessly and inconspicuously. The analyst's task changes from the attempt to maintain that perfect balance Anna Freud (1936) first characterized as equidistance from the psychic agencies to the perception and acceptance of the inevitable imbalances in the analyst's attitudes and the