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Oberndorf, C.P. (1943). Results of Psycho-Analytic Therapy. Int. J. Psycho-Anal., 24:107-114.
(1943). International Journal of Psycho-Analysis, 24:107-114
Results of Psycho-Analytic Therapy
C. P. Oberndorf
1. About 30 per cent. of all cases at present under active treatment by experienced analysts have had previous analyses.
2. Except in the practice of two contributors, very few cases are reported as discontinuing analyses against the wish of the analyst.
3. Hospitalization has been avoided by many patients through psycho-analytic treatment, but the percentage seems to depend very largely upon the character of the individual analyst's practice. One physician whose practice consisted largely of borderline cases places this percentage as high as 66 per cent.
4. The majority of physicians do not approve of review of the analytic situation on the basis of time alone but a strong minority approve the principle of review for manifold reasons.
5. About half do not approve of tapering off treatment but the other half practise it, especially in the so-called borderline cases.
6. Most agreement existed in the criteria for terminating analyses. The principal points mentioned were the capacity of the patient to accept sexuality, better social adjustment and understanding of the mechanisms responsible for the development of the presenting situation.
7. The contributors were equally divided between distinguishing theoretical success and a satisfactory practical result. Here the replies were vague and often coloured by the analyst's theoretical inclinations.
8. In the question of the type of case with which the individual analyst had achieved the greatest success there was practically no unison.
This summary may disclose nothing new or unexpected to many analysts. It may merely confirm what they have long suspected—namely, great disagreement, dissimilarity and disparity of thought on really critical questions among matured psycho-analysts who have been more or less sobered and subdued by countless experiences with the struggles and dilemmas peculiar to psycho-analytic treatment. Still, the extraordinary degree of individualism of analysts in procedure and results may exceed previous supposition. The great divergence exposed may be taken as an indication that the psycho-analytic method can have no fixed application, as pointed out by Dr. Alexander in the concluding remarks of a report of the Council on Brief Psychotherapy. (7)
Dissatisfaction with attempts to apply psycho-analysis inflexibly may account for the endless modifications in technique and theory which are continuously proposed. Sometimes these changes appear to be so slight as to represent a mere shift of emphasis to certain points which seem to have best met the subjective needs and slants of their proponents. Among these may be mentioned Jung, Adler, Stekel and Rank in the earlier period of psycho-analysis and later Ferenczi, after years of close association and harmony with Freud's theory and practice. It may also account for the many deflections which have occurred since Freud's death in the formation of new groups. Each of these innovators seems to be striving unconsciously to attain a personal reassurance, which he seeks to make universal, in modified approaches for what may be a fundamental if still undeterminable weakness in psycho-analytic therapeutic potentialities.
A second type of inference may be gathered from the replies affecting the question of the preparatory instruction of the students in the practice of psycho-analysis. We may well inquire whether a too restricted preparation in psycho-analytic theory is desirable—whether a thorough acquaintance not only with Freud's theories but with their modifications should not be imperative in our institutes. In this way the student may be placed in a position subsequently to develop along lines which may not be in accord with strict Freudian theory and practice. Unconsciously he will favour certain deviations in technique or philosophy because they are well adapted to his personality and psychological leanings.
In response to a questionnaire on the point of quoting the participants by name, the replies showed the same wide variation as on all other points. In deference to those opposing the use of their names, all quotations have been anonymous. In conclusion, may I express my thanks to these unnamed analysts who have supplied the basic materialcontained in this presentation? Here I am sure is one point in which this psycho-analytic audience will be unanimous and join me in an expression of appreciation to these colleagues for their joint contribution to this critique of intricate,
still moot, issues of psycho-analytic practice and its results.
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