Working Through: A Process of Restitution

Working through has been defined as that time required by both the patient and the therapist to “overcome his [the patient's] tendency to repeat a pattern of instinctual discharge in spite of insight which has come from the analyst's interpretations of the resistances.”8 Insight is generally used to designate an intellectual understanding of one's behavior. However, as important is the affective component to the understanding of this behavior. It is this affective component that brings home the intellectual insight and makes a lasting impression on the patient. It is this affective insight which begins the process of change in the behavior of the patient. The difficulty of working through was commented on by Freud3 when he stated: “This working through of the resistances may in practice turn out to be an arduous task for the subject of the analysis and a trial of patience for the analyst.” At this crucial point in treatment, the therapist often loses patience and grows frustrated and tired. This occurs because the therapist usually has been taught that what is necessary in successful therapy is to bring the unconscious into consciousness, to connect affect with insight, and that through some magical reaction the patient will then change his patterns of behavior. Freud alluded to this when he remarked, “It seems that beginners in analytic practice are inclined to look on this introductory step [insight]* as constituting the whole of their work.” Arthur Valenstein9 succinctly put it: “However vital and veritable it may be, there