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In clinical work we are pleased to find patients who have the need and the strength to participate in the full range of experiences which constitute “the pure gold of psychoanalysis.” But it is often true that the condition of the patient precludes the use of the classical technique.† When such occasions arise, the patient can be referred elsewhere or we can decide to render him some other reasonable service. If the latter course is elected, therapy ceases to be strictly analytic in respect to the aim and method of treatment. “Pure gold” is alloyed with the “copper of direct suggestion.”14 Such therapies, however, may remain psychoanalytic in another sense. What need not be set aside, even if the patient is seen for a very short time, is the psychoanalytic view of the elements, the conditions, the dynamic continuities, and the epigenetic plan of human personality.
In recent years, this theory of personality has been combined with modified treatment goals and innovations in technique to provide a new source of rationales for the treatment of a wide variety of disorders. David Rapaport has indicated the purpose of these innovations: “In the long run, psychological theories of therapy must come to a point where they will make it possible to select the therapy which is good for a patient and not a patient who is good for a therapy.”21