Essentials of psychoanalytic cure: a symposium. Introduction and survey of some previous views

Friedman (1978) suggested that implicit in the theories of the psychoanalytic process a classification of three separate trends can be identified. In the first instance, there is what could be called "understanding," whether it be intellectual or emotional. Second, there is "attachment," which refers to curative measures based on some "binding emotional reaction to the analyst." And third, and less explicitly, there is "integration," which refers to the development of a synthesis that has the effect of harmonizing parts of the mind or elevating psychic functioning to a higher level. Freud's writings embodied all three of these trends. The participants of the symposium at Marienbad, being strongly influenced by Strachey's emphasis on superego alteration through introjection, placed the greater stress on attachment. Loewald, emphasizing as he does the importance of the patient's identification with the analyst as a corrective reliving of the origins of identification in childhood, highlights attachment while also relating it to understanding. Stone and Gitelson also focused on the beneficial aspects of the affective link to the analyst and the important function served by this link in facilitating understanding of the analyst's interpretation. At the Edinburgh conference, however, aside from Gitelson and Nacht, who viewed attachment as an integrating or structuring aspect of the analytic process, the participants placed their confidence almost completely on "understanding" strictly through interpretation. In the latest debate between the proponents of self psychology and the object relations approach proposed by Kernberg, many aspects of these previous discussions and controversies have resurfaced (Friedman, 1978). Kohut, utilizing Freud's concept that links gratification and minimal frustration together as the developer of structure, relied on the empathic bond between patient and analyst as a basic component of the process of cure. Kernberg, however, relying predominantly on the conveying of insight through interpretation, is suspicious that this emphasis on attachment might reduce the clarity of understanding and in general prevent meaningful change from occurring. This sounds very much like the reaction of most participants of the Edinburgh symposium to the proposals of Gitelson.(ABSTRACT TRUNCATED AT 400 WORDS)