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The [[psychoanalytic ]] [[treatment ]] is a method for treating [[psychic ]] [[suffering ]] that advances [[self]]-[[knowledge]]. It is characterized by the [[interpretation ]] of the free [[associations ]] of a [[patient]], who in becoming aware of [[feelings ]] and forgotten [[memories]], can thus resolve or express differently the [[unconscious ]] conflicts behind his/her [[neurotic ]] [[symptoms]]. The way sessions are structured—couch and armchair—and their frequency and regularity facilitate this [[process ]] through the transference onto the [[psychoanalyst ]] of affects and [[childhood ]] [[fantasies]].From 1886, when he set himself up in private [[practice ]] to 1909, the year of the "[[Rat Man]]" [[analysis]], [[Freud ]] gradually developed the [[system ]] of [[psychoanalytic treatment]]. In fact the method emerged from the hypnotic treatments that he used after his [[recognition ]] of the failure of medicinal and [[physical ]] therapies in vogue at the [[time]]. Sessions in which the patient relaxed on a couch in an atmosphere of calm and comparative sensory [[deprivation ]] resulted from the [[conditions ]] imposed by somnolescent [[suggestion ]] and later by the "[[cathartic method]]" developed by Joseph [[Breuer ]] to treat his patient, [[Anna O]]. [[Patients ]] themselves contributed towards the [[maturation ]] of the [[structure ]] of the treatment, beginning with Emmy von N's command at their first [[encounter ]] on May 1, 1889, to "Keep still! Don't say anything! Don't touch me!" and her angry [[demand ]] that he stop interrupting and let her [[speak ]] freely.The abandonment of [[hypnosis ]] in favor of an interrogatory [[technique]], and the application of pressure to the forehead to release [[ideas]], [[repressed ]] through [[resistance]], introduced a decisive turn in method, even though Freud appears to have taken a particularly [[active role]] [[role]], insisting patients surrender the pathogenic secrets buried in their unconscious, as the chapter entitled "The [[Psychotherapy ]] of [[Hysteria]]" in <i>[[Studies on Hysteria]]</i> demonstrates (1895d).<i>The Interpretation of [[Dreams]]</i> (1900a) introduced the innovation "free [[association]]," which would become the "fundamental rule" of all psychoanalytic treatment. At the same time the therapist was required submit to the [[principle ]] of "evenly [[suspended attention]]" which entails the scrutiny of even the most apparently insignificant detail (Freud, 1904a).Freud could thus describe his "psychotherapeutic method" in 1904 as follows: "Without exerting any [[other ]] kind of influence, he invites [[them ]] to lie down in a comfortable attitude on a sofa, while he himself sits on a [[chair ]] behind them [[outside ]] their field of [[vision]]. He does not even ask them to close their eyes, and avoids [[touching ]] them in any way, as well as any other procedure which might be reminiscent of hypnosis. The [[session ]] thus proceeds like a conversation between two [[people ]] equally awake, but one of whom is spared every muscular exertion and every distracting sensory impression which might divert his attention from his own [[mental ]] [[activity]]" (1904a, p. 250). Through the transference, whose importance Freud had discovered with his patient [[Dora]], resistance became common, both as an obstacle to treatment and as its major driving force.There remained one last significant innovation in technique, which Freud reported to his disciples at a meeting of the [[Vienna ]] [[Society ]] on November 6, 1907, via an account of the early [[stages ]] of his treatment of the "Rat Man." Otto Rank noted in <i>The Minutes of the Vienna Psychoanalytic Society</i> that "[[analytic ]] technique has been modified to the extent that the psychoanalyst no longer actively seeks to obtain [[material ]] that interests him, but rather allows the patient to follow the unprompted and [[natural ]] course of their [[thoughts]]."Hereafter the framework was determined and has remained to the [[present ]] day. The features that Freud was to [[recall ]] in "On Beginning the Treatment" (1913c) include the [[analyst]]'s [[position ]] outside the reclining patient's line of vision, regular sessions of a prescribed duration, and [[terms ]] for the payment of fees. These conditions create the setting for a "psychoanalytic [[situation]]" in which, for Jacques [[Lacan ]] (1953) and his followers, the principal, indeed the exclusive role, would be one given to [[speech]]; but a speech and an aural attention going beyond [[words ]] to include silences, expressions of [[affect]], and even minuscule movements. Freud had observed this when treating Dora: "If his lips are silent, he chatters with his fingertips; [[betrayal ]] oozes out of him at every pore. And thus the task of making [[conscious ]] the most hidden recesses of the [[mind ]] is one which it is quite possible to accomplish" (1905e, p. 78).Even when supplemented by professional motives (as in [[training ]] analysis), it is [[psychical ]] suffering that compels individuals to consult a psychoanalyst. After one or more preliminary interviews, which Freud advised should not be repeated and in relation to which he preferred "a trial treatment of one to two weeks" (1913c), the direction of the treatment is set out; the two protagonists then decide whether to embark on this venture whose initial [[temporal ]] duration is indeterminate but whose eventual length is assured. "To speak more plainly," added Freud, "a [[psycho]]-analysis is always a matter of long periods of time [. . .] of longer periods than the patient expects. It is therefore our [[duty ]] to tell the patient this before he finally decides upon the treatment" (p. 129).Since Freud some features of this initial framework have changed; thus the six hour-long sessions per week were reduced to five, then to four, and eventually to [[three ]] and the length of sessions has been cut from one hour to forty-five minutes. Following his lead, disciples of Lacan have instituted [[short sessions]], and even sessions whose variable length is based on the analyst's attention to the scansion effect in his patient's [[discourse]], a practice that has been keenly disputed. Some [[analysts ]] believe that two sessions per week is possible, [[others]], that the couch advocated by Freud is in no way an absolute requirement.The [[notion ]] of a "standard treatment" (Bouvet, 1954), which was similar to descriptions of the medical standard that characterized the manuals of the 1950s, was counterbalanced by what were described as its "variants" (Lacan, 1955); it has now been replaced by the "classic" or indeed the "orthodox" treatment for those who see themselves as liberated from its [[formal ]] constraints.It is essential that a "psychoanalytic process" be established and that it is encouraged to advance through the [[development ]] of the transference [[neurosis]], whose [[infantile ]] origins are revealed in analysis, but that it is also always jeopardized by the initiation of a "[[negative ]] therapeutic reaction" which would counter the original [[love]]-based "therapeutic alliance." The analyst's "abstinence" in the face of the patient's [[demands ]] for [[affective ]] [[gratification ]] is a requirement for thisz development, as is his capacity to manage conflicts that may engender "secondary gains" from the [[illness ]] and, once the initial honeymoon period is over, a transferential and countertransferential [[relationship ]] that is as intense as it is unusual. According to Freud: "the therapeutic effect depends on making conscious what is repressed, in the widest [[sense ]] of the [[word]], in the id" (1937c). Analytic interventions address this aim, but more importantly so too do interpretation, [[construction]], and reconstruction (1937d) as well as the analysis of [[resistances ]] and the dispelling of amnesia that masks infantile [[sexuality]]. Active periods alternating with inactive phases, which for Freud were occasionally indicative of a patient's "[[working ]] through" (<i>Durcharbeitung</i>) of the material [[analyzed]], mark the stages of what has been described as "autohistorization" (P. Aulagnier) and highlights the journey towards [[autonomy ]] which will determine the treatment's cessation.The [[termination ]] of analysis has occasioned a [[number ]] of studies since Freud's own (1937c) and is dependent on the aims that the psychoanalyst and the [[analysand ]] have given themselves. Curing the [[symptom ]] has never been the most important function of the treatment and so [[Jacques Lacan ]] could speak of the "cure as [[surplus]]." However, patients do have every [[right ]] to expect relief from the psychic suffering that led them to analysis in the first [[place]], alongside the capacity to better manage the pathological responses that the vagaries of [[life ]] engender through the [[repetition ]] [[compulsion]].The extension of psychoanalytic treatment to more severe pathologies, to borderline conditions and [[psychotic ]] disorders, has altered both the notion of its outcome and the means by which it is reached. Freud's formulation "Where id was, there shall ego [or 'I'] be (<i>Wo Es war soll Ich werden</i>)" and its possible translations has produced a range of possible [[interpretations ]] according to whether the [[Freudian ]] <i>Ich</i> is translated as "ego," as in ego [[psychology ]] for example, or as "I," as in the "[[subject]]."However, the termination of treatment does not mark the end of the [[analytic process]]; its ongoing [[working-through ]] continues in [[self-analysis ]] and in the [[return ]] to the couch, of either the same psychoanalyst or of [[another]], or to an analyst of the other sex or to one from a different [[school]].

# [[Freud, Sigmund]]. (1900a) . The [[interpretation of dreams]]. SE, 4-5.

# ——. (1905e [1901]). Fragment of an analysis of a [[case ]] of hysteria. SE, 7: 1-122.