The author cursorily discusses the problem of which factors are effective in the curing process of psychoanalysis. He classes psychoanalysis as a 'direct psychotherapy' with persuasion (Du Bois), reasoning (Riggs) and individual psychology (Adler). In contradistinction to 'indirect psychotherapy' (occupation, recreation therapy, psychodramatics, hypnosis, shock treatment) which appeal to the emotional needs of the patients, direct psychotherapy is, according to Oberndorf, primarily intellectual in its approach, tracing the development of attitudes from instinctual urges formed in early infancy.
The author complains that this intellectual appreciation of the psychological factors involved in the causation and development of abnormal psychological trends is often woefully insufficient to change them, since such intellectual insight may be kept apart from the personality in a way similar to that of the lack of penetration of the intellectual processes in a manic personality. A depressed patient complained, 'When you are sick you don't accept
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what the analyst says'. A successfully cured patient of Oberndorf did not appreciate the gain of intellectual insight as a healing factor: 'Psychoanalysis is all bunk, but you are a good doctor'.
Certain types of obsessional patients, particularly those in whom intellectual processes have gained a certain godlike or superegolike evaluation, may play the game of intellectual understanding of psychological mechanisms with their analyst for a long time without any change of personality. Oberndorf regrets that 'such a relatively pure form of intellectual psychotherapy—as psychoanalysis—cannot be regarded as truly scientific. We cannot eliminate entirely the possibility of suggestion which is the elusive basis of all indirect psychotherapy.'
Oberndorf does not distinguish between psychoanalytic science and the application of this science to the curing process, which can never consist in a mere communication of scientific knowledge, but represents a highly emotionally charged relation between a patient and a doctor determined by the dynamics of transference and resistance. Oberndorf's criticisms are justified in relation to the shortcomings of psychoanalysts who, in an overvaluation of intellectual processes, neglect to tackle the resistances that isolate intellectual insight from the emotional experience of the personality. Admittedly this isolating resistance is frequently very hard to change. Overemphasis of the intellectual part of the cure may indicate a resistance on the part of the analyst, a lack of simplicity in the human relation and of honesty towards what is emotionally happening between patient and analyst. Oberndorf recognizes that 'the role of an almighty wise god is by no means unflattering and unwelcome to some doctors in a cultural environment which so exalts intellectuality…' Psychoanalysis is an antidote against this intellectual aloofness and Oberndorf's criticisms may hit the shortcomings of some analysts, but not psychoanalysis.
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Weigert, E. (1943). Factors in Psychoanalytic Therapy. Psychoanal. Q., 12:596-597