A Note on the Psychoanalytic Process: The Analysand's Contribution

My effort in this essay on what “cures” in psychoanalysis is to underscore the patient's impact on the therapeutic process. Whereas the focus in the literature concerning the analytic encounter has largely been on the role and the specific theoretical frame of the analyst, the contribution of the patient in shaping the psychoanalytic engagement is either taken for granted or considered of lesser significance. From this perspective, the skills, personality style, theoretical “school,” and the specific interventions of the analyst are highlighted and considered fundamental to the particular qualities of the unfolding analytic process. To add some balance to this view, I am suggesting that, in a complex and interactive way, the analysand's character structure, inner conflicts, and psychopathology profoundly shape the analytic process and to a large degree determine the unique “mix” of what “cures” in the analytic arena.

To place my comments in context, it is important to note that any discussion that attempts to separate out and examine one sector of a complex, multifactorial and interactive process carries with it the hazard of oversimplification, reductionism, and inevitably, a degree of distortion. In such a discussion, it is quite clear that the selective attention must relegate to the background other important factors, as well as put aside those components introduced by the dynamics of simultaneity and mutual interaction.