SEVEN PAPERS ON EXISTENTIAL ANALYSIS ... - Wagner College

later structural model of the “me” (Ich) and the “it” (Es) presented in The Me and the It [Das Ich
und das Es] (mistranslated as The Ego and Id) included a third domain, that of an “overseer of
the me” (Überich). Still compartmentalized, the psyche was still driven by metaphoric energy in
a system of dynamic transformations comparable to but utterly different from the
electrochemical energy that hops between cortical neurons and courses through the nervous
system.
In addition to changing the “object” of treatment, in Freud’s hands the goal and
purpose of treatment also changed. Treatment still implied the existence of something
damaged or broken (a dysfunction) to be repaired, and the goal of treatment was still couched
in the language of improved functioning, the melioration of symptoms and the possible cure of
an illness, but as the Austrian clinician aged and gained in experience, his reasons for analyzing
patients shifted from effecting a cure to assisting the analysand in coming to accept the
vagaries of her personality. Now Freud’s aim was not the curing of a disease, but rather helping
the analysand tolerate being resigned with respect to the inevitability of who she was and had
to be given her earlier life experiences, and by implication what she would have to go on being
as she descended the stairs, walked into the street outside Berggasse 19, and went on with her
life. The goal of psychoanalysis became more modest: embracing “everyday human misery.”
Freud also learned that the process of analysis might even entail having to feel worse for a time.
Like surgery, the “psychic surgery” accomplished by psychoanalysis nearly always entailed a
period of greater pain during and following the procedure than the patient had been
experiencing before entering analysis.
The purpose of this paper is not to continue to review the many incarnations of “the
helping profession. ” Instead I will focus on what I believe to be the goal of all forms of
psychotherapy, one that has been in the background from the beginning (beginning with
psychoanalysis) and continues to gleam (sometimes faintly) through all contemporary “mental
health care”: authenticity. In my view, authenticity is the unacknowledged goal of every form
of psychotherapy, from Freud’s “talking cure” to the current rage, cognitive-behavioral therapy
(CBT). Before doing so, however, I must first examine the notion of intervention, which is implicit
in all forms of psychotherapy, in order to see how it is related to the prospect of regaining
authenticity.
Intervention in psychotherapy is based on the medical approach to human suffering. For
a physician, unless it turns out to be “functional,” a an illness indicates underlying pathology that
(often literally) cries out for examination, evaluation, diagnosis and management—that is to say,
some sort of intervention. [1]
As the root of the word diagnosis suggests, something wants to be known when a
physician approaches an ill person. Of course, many physical disease processes are silent
(asymptomatic), but the symptoms of nervous suffering are visible (anxiety, tension, agitation,
tremor, paralysis, catalepsy, stereotypic movements) and often audible (crying, yelling).
Outspoken like physical pain, such symptoms implore the physician to render an interpretation of
the symptoms and, in psychiatry since the time of Emil Kraeplin, to classify the pattern as a
disorder. Freud added to the system of medical disorders with his new nosology of nervous and
mental diseases. The underlying pathology of the psychoneuroses had to be inferred, however,
since there was no way of demonstrating damage to the psyche’s “me,” the “it” or “my
overseer,” as there might be of verifying damage to a heart or liver. Freud’s early attempts at a
scientific psychology of neurons and Q-energy were abandoned and replaced by a
metapsychology of unconscious mental life that was intended to provide an explanatory
scheme for justifying his diagnosis, say, of hysteria, anxiety neurosis, or obsessive-compulsive
neurosis. [2]
Psychoanalytic treatment was unique in its interventional style, its almost “passive
aggressive” waiting for the analysand’s “free” associations. Its aim was effecting the
verbalization of latent intrapsychic conflicts held to be responsible for the analysand’s
observable or silent (until reported) suffering. The approach attributed agency to intrapsychic