Finally, the practical, therapeutic question arises, as to what measures the
psychoanalyst is justified in taking to bring about the best sort of outcome
in a given case?
It is widely felt that the psychoanalyst would weaken his own hold on the
strong typically analytic principles through which painful conflicts are to
be removed if he should form the habit of dealing with ethical issues, and
talking of "duties", instead of stimulating his patients to the discovery of
resistances and repressions, even of repression the origin of which is not
to be found within the conscious life. Yet,--parallel, as one might say,
with this clear-cut standard of professional psychoanalytic obligation, the
force of which I recognize,--it has to be admitted that there are certain
fairly definite limitations to the usefulness of psychoanalysis. As one of
these limitations, well-pronounced symptoms of egoism, taking the form of
narcissism, are to be reckoned. These symptoms are not easily analyzed away.
But if one asks oneself, or asks one's patients, what conditions might, if
they had been present from the outset, have prevented this narcistic outcome
(Jehovah type, etc.), the influence that suggests itself--looming up in
large shape--is just this broad sense of ethical obligation to which
repeated reference has here been made. If these patients could have had it
brought home to them in childhood that they belonged, not to themselves
conceived of narrowly (that is, as separate individuals) but only to
themselves conceived of broadly as representatives of a series of
communities taken in the largest sense, the outcome that happened might
perhaps have been averted.
And what might have happened may still happen. What is to be done? Each
physician must decide this for himself. He should be able both to do his
best as a psychoanalyst and at the same time help the patient to free
himself from that sort of repression in consequence of which he is unable to
see his own best possibilities. But he cannot do this unless he has trained
himself to see and feel in himself the outlines of this vision any more than
he could help the patient to rid himself of an infantile complex if he did
not appreciate what this complex means. We must trust ourselves, as
physicians, with deadly weapons, and with deadly responsibilities, and we
ought to be well harried by our consciences if we should do injustice, in
using them, either to our scientific or our philosophic training.
ASPECTS OF DREAM LIFE[*]
Public-domain text, read in full here on John Shaqi.
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