The Scope of Psychoanalysis, 1921-1961: Selected Papers

By Franz Alexander | Go to book overview

Psychoanalysis and Psychotherapy
◀1960▶

To speak about psychotherapy and say something which has not been said before on this topic by others and myself is a most difficult assignment. The more we practice psychotherapy, the more we write and speak about it, the more we recognize how much we do not know about its workings, and how little can be stated clearly and with conviction. The same is true for that special form of psychotherapy we call psychoanalysis. Because what is known in this field has been so often stated, I shall this time try to call attention to what we do not know and needs further investigation.

It is a characteristic feature of this field that our practical results are greater than our theoretical knowledge would warrant. We help many patients, both by formal analysis and by the less formalized utilization of psychodynamic principles, without being able to account precisely for our successes and failures. The unpredictability of our results is one of the most conspicuous and also the most disturbing fact in this field.

It is no overstatement that our reputation for a long time was better than we deserved. If I ask myself what is most disconcerting in my relation to my patients, I can say without hesitation that they expect more from me than I feel I can deliver. They come to my office and expect to find answers for their most complex problems, which are the ultimate result of an immense variety of factors: their basic personality equipment, their early experiences, their physical health, the vicissitudes of their fate and their present life involvements, in all of which fortuitous events play an overwhelming role. It is not possible to evaluate precisely how the multiplicity of these variables contributed to their present state. Most of our judgments are primarily intuitive; we can only guess the relative share of these different factors.

The suffering patient has no conception of our relative ig-

-310-

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