On Session Frequency and Analytic Method

This essay differentiates ways the word ‘psychoanalysis’ has been used. Freud's () clinical method required analysts' ‘evenly suspended attention’ and patients' ‘free associations’. Importantly, the direct application of prior knowledge, in the clinical situation, is regarded as an impediment to understanding for both analyst and patient as such ‘knowledge’ may support intellectual, obsessional defences against overwhelming emotional experiences. Frequent sessions over a long time are therefore required in order to understand patients' defences and the anxieties and affective states which led to their creation. The need to discover anew each patient's emotional states as they are lived in the transference–countertransference relationship may be impaired by recourse to prior knowledge. The optimal employment of this method is subject to limitations, however, imposed by a variety of factors, internal and external, to both analysts and patients. Freud (), recognizing this, acknowledged that the discoveries made by psychoanalysts undertaking ‘unalloyed’ analysis had created a body of prior knowledge which might be legitimately used therapeutically to undertake modified treatments of a more directive kind. Unalloyed analysis might need to be combined with ‘the copper of suggestion’ to provide ‘applied’ analytically informed treatments more widely than would otherwise be the case, for example, less frequently. However, having used the word ‘psychoanalysis’ to describe both unalloyed analysis and analysis alloyed, Freud also used the term in a polemical manner and as a kind of ‘brand‐name’. This paper confines itself to these rather different uses Freud made of the term psychoanalysis often without distinction, and the confusions and contradictions which have arisen as a result. These different uses may be largely uncommented upon but have exerted, and continue to exert, an important influence upon both the historical and contemporary analytic discourse.