Analysis Terminable and Interminable

One of Freud's last papers, published in 1937 in the Internationale Zeitschrift für Psychoanalyse: a sober review of what analytic therapy can and cannot achieve. Freud rejects Rank's attempt to shorten treatment by resolving the trauma of birth, and reviews his own expedient of fixing a date for ending the Wolf Man's analysis, whose later relapses showed that such a deadline brings some material to light while burying the rest. An analysis ends in practice when symptoms, anxieties and inhibitions are gone and a relapse seems unlikely; the more ambitious question is whether it can reach a point where nothing more could change. He recounts a former patient, himself an analyst, who years later reproached him for not having analysed a negative transference. Three factors decide the outcome: trauma, the strength of the drives, and alterations of the ego. Cures last best where the cause is mainly traumatic; the taming of a drive holds only as long as the ego is strong enough against it, so the quantitative, economic factor sets a limit, and analysis can neither inoculate against future conflicts nor reach conflicts that are not active, whether by provoking them or by talking about them. The ego's defence mechanisms, useful in childhood, harden into lasting alterations that return in treatment as resistances, even as a resistance against the uncovering of resistances; some differences of the ego are innate, and some patients show an adhesive or overly mobile libido or a general psychic rigidity. Behind the clinging to illness Freud sees the need for punishment and the death drive, whose struggle with Eros he finds anticipated by Empedocles. Analysts, who practise an impossible profession, need an analysis of their own and should return to it about every five years. The paper ends with the bedrock of the repudiation of femininity: penis envy in women and, in men, the struggle against a passive attitude toward other men, which Freud takes to be biological.