The concept of "analyzability" appeared late in the psychoanalytic literature and has two different meanings: One was the classical designation, following the medical model, concerning "indications and contraindications" of the psychoanalytic treatment; the other referred to the realization of a limit to interpretation, that is, the recognition that there is an "analyzable" element and an "unanalyzable" element in what the psyche produces. It was the abandonment of the strict medical model and the attempt to take into account purely psychoanalytic factors that led to the emphasis, when discussing the progress of an analysis, on the concept of analyzability. Preliminary interviews are intended to estimate and, depending on the psycho-pathology of the patient and his capacity for insight, orient the choice of therapy toward a conventional treatment or psychotherapeutic treatment. Some authors, like Elisabeth Zetzel (1968), have, for example, classified hysterical patients into four categories based on their "analyzability." Other authors, especially when discussing borderline patients, have tried to define precise criteria for prognosis. These include Otto Kernberg, who feels that the ability to experience guilt is "a good prognostic sign in the evaluation of the 'narcissistic personality's' analyzability" (1970). The majority of authors, however, although they do not recommend the use of trial treatments as Heinz Kohut did (1971), following Freud, recognize that the only way to judge a patient's receptivity to analysis is through the process of analysis itself.
The other meaning refers to the limitations of what can be analyzed. Early in his career Freud put forth the idea that not everything was subject to interpretation and that we had to acknowledge the unknown element in the psychic material studied, even if clinical and theoretical efforts were intended to reduce the impenetrability: "The best-interpreted dreams often have a passage that has to be left in the dark, because we notice in the course of interpretation that a knot of dream-thoughts shows itself just there, refusing to be unraveled, but also making no further contribution to the dream-content. This is the dream's navel, and the place beneath which lies the Unknown" (1900a, chap. 7).
To this constraint on the "interpretative frenzy" (as Sándor Ferenczi described it) of some psychoanalysts was later added a discussion and evaluation of the limits of the effectiveness of psychoanalysis. In "Analysis Terminable and Interminable," aside even from the limits imposed by the resistance of the id, the "viscosity of the libido," or negative therapeutic reactions, Freud concluded, "We often have the impression, in the case of penis envy and masculine protest, of having opened a passage through the psychological strata to 'bedrock,' and to have thereby completed our work. Yet it cannot be otherwise, since for the psychic, the biological indeed plays the role of the underlying bedrock" (1937c).
- Indications and contraindications of psychoanalysis
- Initial interview(s)
- Preconscious, the
- Transference neurosis
- Transference relationship