| Abstract: | The time frame of psychoanalytic long-term treatment depends on the therapy goals and the means by which these are expected to be reached. A core element for this is the concept of working through. In Freud’s view working through deals with resistance towards the acceptance of an interpretation regarding unconscious conflicts. Also, in classical terms there is a working through of the transference neurosis. Conceptual intertwining with the work on mourning (in terms of libidinal decathexis) brings a difficulty to light, namely the potential danger of misusing long-term treatment and the therapeutic working relationship for avoiding termination and separation. The basic concept of working through can be maintained for patients with non-neurotic disorders as well as regarding modified psychodynamic psychotherapies with fewer sessions and lower session frequency, albeit in consideration of the theory of therapeutic change for each form of treatment; however, a three-fold meaning of working through in contemporary psychoanalysis (i.e. working through of resistances, working through of transference neurosis and the structurally changing inner work of the patient) indicates the need to discuss the necessary duration of long-term treatment neither from a viewpoint of economic efficiency nor from a standpoint of mere professional policy but to base this on the logic of the dynamics of a disorder and the treatment planning. |
