8. Means, Ways, and Goals

The structure of numerous social events is based on the categories of time and place. The regular club evenings, the Wednesday meetings in Freud's apartment, church on Sunday, and summer vacations at the same place every year are just a few examples of the biologically and socially based rhythm of life. Regularity can reinforce identity. We now want to examine the issue of the frequency of treatment from this perspective about the organization of experience.

Even though Freud introduced his “principle of leasing a definite hour” for pragmatic reasons, the daily session was nonetheless important to prevent treatment from “losing contact with the present,” by which he meant a patient's life outside analysis (1913c, pp. 126-127). Yet we also must take into consideration the fact that the treatment itself can become a patient's present, i.e., the decisive factor in his life. More recently it has become possible to observe a tendency away from daily sessions, as Freud practiced them, and toward analyses of varying intensity. This tendency is motivated by strategic considerations, that is by the attempt to be flexible in finding solutions:

The specialized yardstick for the temporal intensity of treatment is one which registers which combination of structuring, confrontation, and assimilation is optimal for the dynamic of treatment, given the observation and participation of the analyst and taking into consideration relevant events and the patient's experiences outside the analytic situation, his assimilation of them between sessions, and the goals of treatment. (Furstenau 1977, p. 877)

Alexander and French (1946, p. 31) suggested controlling the intensity of transference by varying the frequency of sessions — which met vehement resistance. What is it, then, that moves us to retain the frequency originally chosen and to alter this arrangement only after long and careful reflection? This raises an interesting point: on the one hand, the frequency of sessions is v