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Gabbard, G.O. (2001). Overview and Commentary. Psychoanal Q., 70(1):287-296.

(2001). Psychoanalytic Quarterly, 70(1):287-296

Overview and Commentary

Glen O. Gabbard, M.D.

The decision to devote an issue of The Psychoanalytic Quarterly to the goals of clinical psychoanalysis is a timely one. A lack of clarity about goals has undoubtedly damaged the credibility of the whole psychoanalytic enterprise in the eyes of fellow mental health professionals and in the eyes of society in general. As Goldberg notes in his contribution, “As much as we would like it to be otherwise, we are haunted by vagueness” (p. 128). This vagueness takes many forms. Are we speaking of the psychoanalyst's goals or the patient's goals? Are we referring to conscious or unconscious goals? Process or outcome goals? Do we even endorse the notion of goals for a psychoanalytic treatment, or is psychoanalysis essentially goalless? Is there still a valid distinction between psychoanalytic and psychotherapeutic goals, or between treatment goals and life goals?

These dilemmas are not new. They were present at the dawn of psychoanalysis, when Freud struggled with the dialectic between the psychoanalytic approach as a way to help the patient recover from an illness, and psychoanalysis as a research tool to investigate the human mind. In 1904, he clarified: “The task consists of making the unconscious accessible to consciousness, which is done by overcoming the resistances” (p. 253). He then went on to say, The aim of treatment will never be anything else but the practical recovery of the patient, the restoration of his ability to lead an active life and in his capacity for enjoyment (p. 253, italics in original). In addition, of course, the tension between an optimistic view of what analysis might achieve and a more pessimistic one of its limitations is a ubiquitous thread running throughout Freud's writings (Sandler and Dreher 1996).

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