Chapter 9. The Psychoanalytic Process: Treatment and Results

Introduction

Some of the psychoanalytic treatments presented in this chapter go back to the form of systematic case study we mentioned in Sect. 1.3. Nostalgia is not the reason that we refer back to therapies that are long past; the reason is that the long follow-up periods are an excellent basis for discussing the outcome of therapy. The research into the process and outcome of psychoanalysis that we have initiated in Ulm has developed out of our experience with systematic case studies (Thomä 1978) and the investigation of interpretative actions (see Sect. 8.3); the results of this research have motivated us to adopt a new understanding of the psychoanalytic process (see Vol. 1, Chap. 9). More is expected of this research than we can present in this textbook, which for didactic reasons must have a broad clinical basis and include a large number of different cases. The combined research into the process and outcome of psychoanalysis with respect to individual cases, which we and others have propagated, is still in its infancy (Grawe 1988). If we were to describe such cases in the necessary detail, then this textbook would consist of only one of them.

The important therapeutic changes in cases other than those presented in this chapter can be followed without any great effort by reading the individual cases referred to throughout the book in sequence (see the index of patients at the beginning of the book). In addition, Sects. 5.1–5.3 contain descriptions of typical excerpts of an analysis, selected with regard to a series of dreams, and Sect. 6.3.1 contains an excerpt of an analysis prepared for a referee within the peer report system of applying for health insurance coverage.

This chapter begins with a section entitled “Anxiety and Neurosis;” we know of no better place to discuss this important topic. This section (Sect. 9.1) provides the reader a survey of the psychoanalytic theory of anxiety, which is followed by th