Siginnnd Ready Glut xxv l ‘THE FUTURE PROSPECTS OF PSYCHO- [ ANALYTIC THERAPY * [Aw ADDRESS DELIVERED BEVORE THE SECOND INTER NATIONAL PSYCHO-ANALYTICAL CONGRESS AT Nunempere 1% 19:0 (2910) oday are mainly practical, 1 shall choose a practical theme for my introductory address and i 2ppetl to your interest in medical, not in scientific, : ravers.” Yeap imagine what your opinion about the Success of our therapy probably is, and T assume that fmost of you have aitady passed through the, two Sages which all beginners go through, that of en- {hstasm at the unexpected increase io our therapeutic Achievements, and thet of depression at the magnitude |] hte eiiclties which stand in the way of our efforts GWichever of these stages in development, however, tach of you may happen to be going through at the | |] moment, "my" intention to-day is to show you that wre have by no means come to the end of our resources || Torcombating the necroses and that we may expect a || substantal improvement in our therapeutic prospects before very long | “This improvement will come, I think, from three 1. From intemal progress. | 2, Brom increased prestige \ 3. From the general effect of our work sug Bee te pe on Set he objects for which we are assembled here286 couiecren ravens xv 1. Under intemal progress" I understand advances {a} in our analytical knowledge, (2) in ont technique. (a) Advances in our knowledge, We ate, of Curse, stil long way from knowing all that ie required fo an understanding of the uneonscious minds of our patients. "Now itis clear that every advance in our Knowledge means an increase in the power of Out therapy. As long as.'we understood nothing, we accomplished nothing; the more we understand. the Tore we shall achieve. At its beginning. peycho- shal tamer as inexoabe an anaute ‘The patient had to Say everything himself andthe pPhyskian’s part consisted of ging him on inocse they Today things have a more friendly ar. The treatment js made up of two parts, out of what the physician infers and tells the patient and out of the patients work of assimilation of “working through’, what he hears. The ‘mechanism, of our ‘curative method. i Indeed quite easy to understand; we give the patient the conscious idea of what he ‘may expect to find (Penis Erwartungsvorstlung), andthe similarity of this with the repressed tnconscious one leads him to come upon the latter himself This i the intellectual help’ which makes it easier for him to overcome the teghtancs Getneen ona and neonate Gidentally, I'may" remark that it is not theo mechanism made use of by the analytic method You all know that far more powerful one which es in the use of the “transference 1 intend soon to tndestake an exposition of these vatious factors Which ies important fora onderstandng othe crn a Practice of Psycho-Analysis. And, further, in peaking fo you I need not rebut the objection that the wey Jn which ‘we practise the method totay obscures its testimony to the correctness of out hypothesess yout will not forget that this evidences t0'be found dee: Iwhere,and that a therapeutic procedure cannot be per. Formed in the same way as a theoretical investigation, ‘Now let me reler briefly to various feds if which gt FUTURE OF PSYCHO-ANALYTIC THERAPY 287 Tat foo dstane fom ons had sezacked! fo oof us of coitus. “The underlying element which the tivo Fraps can be down Beto agun. ue the ehyth of to adduce the usages of speech in this fconnection. “Tt Shak ace beeen ofa stair are called marches"; ‘a wus marches Gream-material_ from which these newly recognized288 COLLECTED PAPKRS xxv Jahrbuch, However, I mast break off here of T shall hot reach my other points, Every one of you will know from his own experience the total change in one's attitude to a new case When ‘nce one has thoroughly mastered the stracture of some typical cases of illness. Assuming now that we had harrowiy. defined. the regular eletents in the com= Paton of the eros frm of neuron jet ate fave already succeeded in ding for hysterical sympton- formation, how much more assured we should he fn four” progroses! "Just as an" obstetrician knows xamining the placenta whether it has been completely expelled ‘or whether noxious fragments of it stil femain, so we should be able, independently of the Success of the cute and the patient's present condition, to'say whether the work hed been completely caried (0 an end of whether we had to expect relapses and fresh onsets of ines {2) Twi hasten on to the innovations in the field of technique, where indeed” nearly everything till Awaits definitive settlement, and much only AoW incgimning te come clear” There ate now two aims in paychowanalytie technique! to save. the physician Ror end to open up fr the patent the feb aces {o hs unconscious, "You Know that our technique teen transfomned in iportant respects, “At the time Of the cathartic treatment we set ourselves the aim Of chucdating the symptoms, then we turned away from the symptoms to discovering the * complexes", to's Jung Indinpensable word; now, however out Work is aimed directly at finding out and overcoming the resistances", and we can mith justieaton raf onthe complexes coming to. light as soon ag. the fesistances have been recogoized and removed, “Some Gf you have since shown'a deste to formulate and Gladily these feistances, Now T beg you to examine {your material and see whether you'can conten the Talowing Statement’ In. male patients the most Important resistances "the treatment sem 0: be glo FUTURE OF PSYCHO-ANALYTIC THERAPY 289 derived from the father complex and to express them Stives in fear of the father, and im defence and incredulty towards him ‘Other’ innovations in technique relate to. the poysidan hime We have: begun to onside, the counte-transference’ which aries in'the physician asa rest of the patient's inftuence on his unconscious feng and have nay come to the pont of requing the phiysiclan to roogntze and overcome tis counter: transference in Kimeell. "Now that a larger number of people have come to practise peycho-snalyats and inutwally exchange their bxperiences, we have noticed that every analyst's achievement i limited by what his own complexes and resistances permit, and con- sequently we require that he should begin his practice wth a selfanalysis snd. should extend and. deepen This constantly while making his observations on his plients. Anyone. who cannot_succsed in this sll: Tnalysis| may without. more ado regard. himself 2s unable to treat neurotcs by analysis ‘We are alio now coming to the opinion that the analytic technique most undergo certan modifications aceotding tothe nature of the disease and the dominat- ing instinctual. trends in the. patient. Our therapy wren, Infact, first, designed for conversion hystere Invanxiety-hysteria (phobias) we must alter” our Procedure to some extent. The fact is that these Patients cannot bring ost the material necessary for fesolving the phobia to long as they feel protected by retaining thetr phobic condition. One cannot, of course induge them to give up their protective meastres and. work under the influence of ansiety from the ieginning of the treatment. One mast therefore help them by interpreting their unconscious to them until they. can male up thee minds to do-without the protection of their phobia and expose themsaves (0 a Tow comparatively moderate degree of anxiety. Only when they have done s0 does the material necessary {or achieving solution ofthe phobia become accesible.