In this interesting paper Eissler discusses the relationship between analytic technique and analytic theory, or, more specifically, between technique and ego structure. The basic modeltechnique uses interpretation alone and is applicable to hysteria, where there is minimum ego damage. Deviations from this basic technique are required in other conditions, such as phobias, obsessive-compulsive reactions, delinquency, and schizophrenias, in which ego damage is more extensive.
The term parameter is defined as 'the deviation, both quantitative and qualitative, from the basic modeltechnique, that is to say from a technique which requires interpretation as the exclusive tool'. The criteria of a parameter if the technique is to remain psychoanalytic are listed. The parameter employed in the analysis of phobia is regarded as the model.
The basic technique without deviation can be applied effectively to patients with no noteworthy modification of the ego. The behavior of the ego when the basic technique is used demonstrates whether or not the ego has suffered modification. According to Freud a normal ego is one which would 'guarantee unswerving loyalty to the analytic compact'. Personality structures can be classified according to the techniques needed to deal with their defects. For this classification the author suggests using Freud's concepts: 1, a hypothetically normal ego as defined by its response to the basic technique; 2, a scale leading by degrees to the condition of absolute unresponsiveness to the analytic compact; and 3, an intervening variety of ego modifications in which a variety of techniques must be correlated.
Ego change is distinguished from ego modification, and the cause of ego modifications is discussed. Defense mechanisms have a destructive effect on the ego, especially in schizophrenia, in which ego modifications are most conspicuous. In schizophrenia the defensive apparatus is kept in motion by energy which has not been desexualized or neutralized. Certain defects of the ego in schizophrenia and two parameters needed in its treatment are considered.
The author takes up the problem of secondary defenses, one of the main functions of which is to prevent the spread of the primary defenses. These probably form part of a special organization within the ego, and whether ego modification can be altered by psychoanalysis depends on these secondary defenses.
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(1954). Journal of the American Psychoanalytic Association. I, 1953. Psychoanal. Q., 23:295-295