1.1 Survey of Basic Concepts: The Historical Development of Psychoanalytic Therapy

One way of ascertaining what is essential in psychoanalytic therapy is to take a bird's-eye view of its historical development and to note the major changes in the technical procedures and in the therapeutic processes. What follows is a selective summary of the highlights of Freud's writings on these matters. A more detailed investigation of each subject, including the contributions of others, will be found in the appropriate place in the text that follows.

Let me clarify the terminology. I am using the term technical procedure to refer to a measure, a tool, a course of action, an instrumentality, undertaken by the therapist or the patient, with the purpose of furthering the therapeutic processes. Hypnosis, suggestion, free association, and interpretation are examples of technical procedures. A therapeutic process refers to an interrelated series of psychic events within the patient, a continuity of psychic forces and acts which have a remedial aim or effect. They are usually instigated by the technical procedures. Abreaction, recapturing memories, and insight are therapeutic processes. (See E. Bibring [1954] for a similar but more comprehensive methodological approach.)

Psychoanalytic technique was not suddenly discovered or

invented. It evolved gradually as Freud struggled to find a way of effectively helping his neurotic patients. Although he later disclaimed any enthusiasm for therapy, it was his therapeutic intent which led to the discovery of psychoanalysis.

Freud was an astute clinician and could discern what was meaningful in the complicated sequences of clinical events that followed the various technical procedures he employed. He also had a gift for theoretical and imaginative thinking which he blended together to construct hypotheses relating technique to clinical findings and to therapeutic processes. Fortunately, Freud possessed that complex combination of temperament and character traits that enabled him to be a conquistador, an “adventurer” of the mind