The Aim of Psychoanalysis
The goals of a therapy offer a clear definition of what the therapy conceives health to be . In Outline Of Psychoanalysis, Freud offers his idea and goal of analysis: "Is it too bold," he asks , "to hope that it must be possible to submit the dreaded spontaneous illnesses of the mind to our control and bring about their cure?"
Obviously, Freud conceived the task of therapy to be one of control -- of getting the illness to submit. Later, he uses the metaphor of war to describe the alliance of the patient and analyst against the illness:
The analytical physician and the weakened ego of the patient...are to combine against the enemies, the instinctual demands of the id, and the moral demands of the superego.Freud is saying that patients must exist in a state of permanent warfare -- cold warfare, perhaps -- and that the analyst must join the battle as an ally to help the ego in its task of "keeping down the instinctual claims of the id." The chief armament is the intellect, both the patient's and the analyst's:
Our knowledge shall compensate for his ignorance and shall give his ego more mastery over the lost provinces of his mental life.Unfortunately, neurosis is not an illness of ignorance, and the business of therapy is not compensation -- especially not in the currency of "our [the analyst's] knowledge." Neurosis is an illness of feeling, and the patient has his own knowledge to discover through his feelings. No amount of received information will make up for what he can recover from his own unconscious. Furthermore, "the lost provinces" is what has made him unwell in the first place. Therapy must be a voyage of discovery. A patient must never lose his curiosity or the thrill of self-discovery. If the dialectical process of Pain and liberation, agony and discovery is not addressed, than a "cure" will remain elusive.
The cognitive focus of psychoanalysis is made plain in the Outline. So is the canonization of the analyst as a beneficent provider of health-giving wisdom. No matter how knowledgeable and wise the analyst, his wisdom is not curative. No amount of his acquired learning is as valuable to the patient as the patient's own history and feelings. Only the patient's own natural processes can bring him health.
Freud wrote in the Outline:
The new superego (analyst as substitute father) now has an opportunity for a sort of after-education of the neurotic; it can correct blunders for which his parental education was to blame.And later:
The method by which we strengthen the pa-tient's ego has as its starting point an increase in the ego's self knowledge. Thus the first part of the help we have to offer is intellectual work...And:
(We are) in a position to conjecture the nature of his repressed unconscious material and to extend, by the information we give him, his ego's knowledge of his unconscious.From all this we learn that analysis works from the premise that the problems and solutions to neurosis lie in the thinking brain -- and more often than not, in the thinking brain of the analyst. We also get an idea of how Freud saw his own role in therapy: "We serve the patient in various functions as an authority and a substitute for his parents, as a teacher and educator..." Add to these interpreter, sage, restorer, ally, corrector, critic, detective, historian, persuader and superego, and we have quite a formidable figure. Certainly Freud's followers took their cues from this vantage point.
For many, the Freudian therapist is too presumptuous, and condescending, shrouded in the veil of his own fund of esoteric knowledge; knowledge which was itself intellectually obtained like a catechism. The analyst's attitude is built into the theory, for the analytic process assumes the omniscient, all-powerful authority figure therapist. Her presence should not intrude upon the patient nor obscure the patient's own light.
Since the patient is suffering from a disease of feeling, it is erroneous for the analyst is treat him with intellectual medicine. The power of the process must be shifted from therapist back to patient. One principal task is to provide an environment in which a patient can stop intellectualizing and start feeling. A restrained, intellectual, "proper" analyst exudes and circumscribes the kind of atmosphere in which the patient behaves. A stiff-tie, starched-shirt milieu is not conducive to feeling. It is no different for a child with his parents. If they are free, warm and feeling, the child automatically becomes feeling without one word said about liberty and freedom. The atmosphere is absorbed by a child who lives inside it with no particular awareness. The same is true in the therapist patient relationship. Humility is built into that relationship when the ultimate power and knowledge reside in the so-called "sick" one.
_Translated by James Strachay (New York: W.W. Norton), 1949.