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The dictum that the patient's neurosis is converted into a transference neurosis of which the analysis endeavours to cure him, may be an oversimplification but it has more than a grain of truth in it. In so far as the analysis enables the patient to gather together into a single relationship the diverse threads of his infantile transference tendencies, it can be seen to make a concentration of infantile need, anxiety and affect which has every resemblance to an illness. Where this replaces processes of symptom formation that were hampering the patient's activities and relationships in the outside world, it may appear as a benefit to the disinterested observer. But where the emotional disorder in the personality has been bound in character or in patterns of relationship, the concentration and potentiation of the transference processes made possible by the psycho-analytical setting may show as an illness in a person previously considered well and well-adjusted by family and friends. This is perhaps most often seen in people who come to analysis not from motives of therapy, but for professional reasons of one sort or another.
Fifteen years ago (The Psycho-analytical Process, Heinemann, London, 1967) I suggested the usefulness of viewing psychoanalytical treatment from a process point of view, that is of a continuum of transference-countertransference events which the analyst monitored, contained in his setting, and tried to assist with interpretation. In this view the content of the process was seen to emerge from the unconscious of the patient as an externalization of his internal object relations and narcissistic organization, while the analyst was described as “presiding” over its evolution. It was a view that had become borne in upon me mainly through work with children but which had proved equally applicable to the situation with adult patients.
Since that time my explorations of technique have been closely related to this process view and in some papers I have trie