This is a critical analysis of the theories and methods of treatment of the 'Chicago School' as described in Psychoanalytic Therapy: Principles and Application by Alexander, French and others. Their deviations in theory and technique from those of Freudian analysis are described in some detail.
The Chicago theories cannot rank as a stage in the development of the classical tradition of psycho-analysis; this 'sixth period' shows little sign of organic derivation from the previous line of analytic development. The main thesis is that Alexander and French's methods are not in any real sense psycho-analytic, although described as such.
Alexander's definition of neurosis is superficial, nearer in type to Adler's conceptions than Freud's: his views regarding the origin of neurosis are not validly derived, since he discounts the importance of infantile traumata and leaves the genesis of the neurosis unexamined. His theory of transference and resistance approximates to the Adlerian concepts—neurotic withdrawal from difficult life-situation and resort to infantile fantasy gratification.
They claim to have a new technique for the handling of transference and regret the inordinate length of psycho-analytic treatment, which they attribute in part to the faulty handling of transference. Eissler criticizes the remedies they propose for handling this problem.
Regarding the results of their treatment, even in their own descriptions of their therapeutic achievements,
- 268 -
their patients do not seem to have made any progress in their capacity to test psychic reality, although the façade of their personalities may be considerably changed.
The aim of psycho-analysis is a structural change. The type of clinical improvement achieved by Alexander and French's methods, and named by them psycho-analysis, says Eissler, represents nothing more than a change of content. The authors have 'not reported one instance of structural change' and therefore should not call their book 'Psychoanalytic Therapy'.
The discussion of this section is detailed and very interesting in illustrating how deviations from analytic practice in the interests of shortening the treatment period materially alter the efficacy of the treatment.
Alexander's position in 1949 is in some respects very near to Freud's position of 1900, i.e. prior to the introduction of the structural aspect into psycho-analysis.
The type of treatment in which Alexander shows his greatest success is that which effects an anxiety-relieving adjustment in personality with consequent real gains in general competence, but Eissler emphasizes that this treatment is in no sense psycho-analysis and that the 'new' technique has misadapted some elements of psycho-analytic technique in the service of a relatively superficial psychotherapy.
The lack of wisdom on the part of the authors in taking their patients' reports at their face value is criticized, also their advice on planning treatment.
Some possible sociological and personal explanations for the desire shown by certain analytic groups to find methods of shortening treatment time are mentioned.