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Abrams, S. Welsh, H.K. (1990). The Nature of the Therapeutic Action of Psychoanalysis: How Analysis Works. J. Amer. Psychoanal. Assn., 38:773-788.

(1990). Journal of the American Psychoanalytic Association, 38:773-788

The Nature of the Therapeutic Action of Psychoanalysis: How Analysis Works

Samuel Abrams, M.D. and Howard K. Welsh, M.D.

ABRAMS INTRODUCED WAYS THE AUDIENCE could orient to and organize the presentations. He noted that psychoanalysts share an allegiance to certain terms, e.g., transference, resistance, psychoanalytic process, therapeutic action. Despite this, there is evidence to suggest that the terms are defined, understood, and applied differently. Is there an identifiable enterprise that can be called clinical psychoanalysis, or is psychoanalysis comprised of a glossary of ambiguities? If clinical psychoanalysis is many things, the common qualities that unite all of them under one flag should be demonstrable, if singular, its differentiating essence should be demonstrable. A panel on therapeutic action might be ideally suited to find such an essence. What could this panel hope to achieve?

Abrams suggested trying to organize the ambiguities and controversies, offering ways of listening to the panel that could allow the audience to categorize whatever is proposed so that it could judge how truly different the assertions are and what to make of the differences.

Abrams conjured up a hypothetical panel convened in 1897 on the concept of how analysis works. He assumed the panelists then would have been united in their positions. One of the panelists would have said this about the how: analysis works by offering a pathway of discharge of strangulated sexual excitation. Another might have understood the question in operational terms, that is, how the analyst encourages the process of cure. He would have said that it works because the analyst facilitates discharge routes, like a surgeon incising an abscess.

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