THE AIM OF PSYCHOANALYTIC THERAPY* 1 Within the broad expanse of the discipline of medicine, which aims at the preservation and restoration of health and the prolongation of life, there exists the subdivision of psychiatry whose special field of endeavor is the furtherance of mental health. Because the study of mental health embraces all that is human in the widest meaning of the word, it has remained difficult for the psychiatrist to state his objectives, describe his techniques and define his subject matter with the precision and specificity which generally prevail in other divisions of the biological sciences. It has been a peculiarity of psychotherapy in particular, which considers everything pertaining to mankind as legitimate grist for its mill, that a statement of its aims and of an economical procedure for their achievement has not been set forth with that clarity which commends itelf to the scientific mind. It is certainly true that, with the continuing refinement of psychoanalytic technique and the ever accumulating insight into human nature which has resulted therefrom, psychotherapy has achieved a direction and purposiveness which justify its claim as a logical method for the treatment of personality disorders. Nevertheless, the psychoanalyst finds himself rather frequently beset by a disconcerting difficulty in the accurate delineation of the aims toward which his efforts are directed, although this difficulty is only a specific instance of the general problem to which mankind will probably always be heir, namely, the question of how to lead the good life. If the goals toward which the psychoanalyst strives are not always as clear in his own mind as he would like them to be, how much more so must this be the case of the unhappy victim of psychoneurosis or other emotional disorder who seeks his aid? Indeed, the patient who presents himself for psychoanalytic treatment and who invariably has only a skimpy familiarity with the details of his illness, feels only too clearly in his own mind the chief end result of his disability, namely, that he is drifting through life in a rudderless manner, not knowing what he wants nor how to proceed in an effective manner toward the few evanescent goals which occasionally appear attractive, however temporarily, to him. While it is plain that, in greater or less degree, the psychoanalyst has been successful in finding practical methods of presenting both to himself and to his patient the aims of the psychotherapeutic endeavor, it seems highly desirable to have a simplified statement of goal to which both patient and physician can subscribe, comparable to that of general medicine, viz., health. Such a simple statement of the hallmark of the well ordered mental economy, which is acceptable to both physician and patient, which is in fact constantly striven for in all psychotherapeutic endeavors, is the achievement of happiness. While both patient and psychoanalyst will probably be quick to agree that the ultimate goal of their cooperative efforts is the achievement of durable happiness for the patient insofar as reality permits, there is likely to be considerable difference of opinion as to what constitutes happiness, which forces operate in favor of it and which militate against it, and what is the most effective method for the attainment of that desired state. The answers to these questions will vary according to the discipline which is being brought to bear upon the problem; but any discipline which purports to institute or enhance a state of happiness will contribute something to the desired aim, provided its tenets are based on trustworthy evidence, and, in theory at least, these varied contributions should be susceptible to the employ of the psychoanalyst. Thus the cleric would probably state that happiness is to be gained through love, that the greatest forces available during the quest for the loving state are faith in the fact that love exists and hope that one will find it, while the most effective technique for gaining happiness is the practice of charity, which is repetitive exercise in the act of loving. …
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