Nathan Roth, M.D.: “The Aim of Psychoanalytic Therapy”

Abstract

In 1955, psychoanalytic theory and therapy reached their zenith of popularity in the United States, with a relatively well-established consensus as to what constituted psychoanalytic technique and process. From today's perspective, Roth's paper illustrates how much psychoanalysis and psychotherapy have evolved since the 1955 model. The emphasis then was on the goal of achieving which was seen as being based on the achievement of truth; the importance of drive theory; the impact of a punitive, restrictive, and oppressive superego inhibiting the individual's capacities to exercise his abilities in the pursuit of happiness; and the role of the analyst as making information available to the patient through interpretation. Roth describes the origin of the superego as the internalization of the parental demands, values, and obligations that inevitably has detrimental influence upon the originality and spontaneity of the (p. 516). He also emphasizes that the somatic channel, be it oral, muscular, visual, etc., affords the child the most satisfaction for the prohibited instinctual impulse. It is being conceived as the channel through which the prohibition becomes incorporated into the superego. Roth has not yet recognized the role of the child's fantasy and the child's own aggression and envy projected onto the parents in the formation of superego function. The somatic route of internalization would, today, not be emphasized so specifically, and concepts of superego function today include the balancing positive aspects of superego values and the existence of benign, loving and rewarding superego capacities. Throughout the paper, the emphasis is on a one-person focus of the patient's psychopathology and psychic function, and the idea of the interactional two-person process of today has not yet evolved. Emphasis is on the imparting of understanding through the analyst's interpretations and interventions, and the patient making use of them to alter behavior. The paper presents a brief case vignette focused primarily on the patient and his psychopathology, and the explanation of the patient's distress and symptoms is discussed around the issues of infantile masturbation as the patient's major source for expressing and discharging instinctual tensions. Roth posits that a most important factor in keeping the patient from fully deploying his intellectual abilities and executive talents was the muscularly transmitted authoritarian image prohibiting infantile masturbation. He concludes that in order to rediscover happiness, the patient had to be steered in the direction of much greater permissiveness and total dissolution of some portions of the infantile superego. In today's formulation of the psychoanalytic process, the role of superego is one of many components. …