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No general rule can be laid down as to the right time for resorting to
this forcible technical method: the analyst must use his own tact
in the matter. A mistake, once made, cannot be rectified. The saying
that the lion springs once and once only must hold good here.

II

The discussion of the technical problem of how to accelerate the
slow progress of analysis suggests another deeply interesting question:
is there such a thing as a natural end to an analysis or is it really
possible to conduct it to such an end? To judge by the ordinary
talk of analysts we should presume that it is, for we often hear them
say, when deploring or excusing the admitted imperfection of some
fellow-mortal: ‘His analysis was not finished’ or ‘He was not
thoroughly analysed’.

Now we must first decide what is meant by the ambiguous term,
‘the end of an analysis’. From the practical standpoint it is easily
defined. An analysis is ended when analyst and patient cease to
meet for the analytic session. This happens when two conditions
have been approximately fulfilled. First, the patient must no longer
be suffering from his former symptoms and must have overcome his
various anxieties and inhibitions and, secondly, the analyst must have
formed the opinion that so much repressed material has been brought
into consciousness, so much that was inexplicable elucidated, and so
much inner resistance overcome that no repetition of the patient’s
specific pathological processes is to be feared. If for external reasons
one is prevented from reaching this goal, it is more correct to say
that an analysis is incomplete than to say that it has not come to an
end.

The second definition of the ‘end’ of an analysis is much more
ambitious. According to it we have to answer the question whether
the effect upon the patient is so profound that we can be certain that
no further change would take place in him if his analysis were con-
tinued. The implication is that by means of analysis it is possible
to attain to absolute psychic normality and to be sure that it will be
maintained, the supposition being that all the patient’s repressions
have been lifted and every gap in his memory filled. Let us first
consult our experience and see whether this really happens and then
examine our theory and learn whether there is any possibility of its
happening.

Every analyst will have treated some cases with this gratifying

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result. He has succeeded in clearing up the patient’s neurosis, there
has been no relapse and no other nervous disturbance has succeeded it.
We know something of what determines these results. No noticeable
change had taken place in the patients’ ego and the causation of their
illness was pre-eminently traumatic. The ætiology of all neurosis is
indeed a mixed one; either the patient’s instincts are excessively
strong and refuse to submit to the restraining influence of his ego or
else he is suffering from the effects of premature traumas, by which
I mean traumas which his immature ego was unable to surmount.
Generally there is a combination of the two factors: the constitutional
and the accidental. The stronger the instincts the more readily will
a trauma lead to fixation, with its sequel in a disturbance of develop-
ment; the more violent the trauma the more certain is it that it will
have injurious effects even when the patient’s instincts are of normal
strength. There can be no doubt that, when the ætiology of the
neurosis is traumatic, analysis has a far better chance. Only when
the traumatic factor predominates can we look for that most masterly
achievement of psycho-
analysis, namely, such a reinforcement of the
ego that a correct adjustment takes the place of that infantile solution
of the patient’s early conflicts which proved so inadequate. Only in
such a case can one speak of a definitive end to his analysis. When
such a result has been attained analysis has done all that can be required
of it and need not be continued. If the patient who has made such a
good recovery never produces any more symptoms calling for analysis,
it still, of course, remains an open question how much of this immunity
is due to a benevolent fate which spares him too searching a test.
The factors which are prejudicial to analysis and may cause it
to be so long-drawn-out as to be really interminable are a constitutional
strength of instinct and an unfavourable change sustained by the ego
in the defensive conflict, a change comparable to a dislocation or
crippling. One is tempted to make the first factor–
the strength of
the instincts–
responsible for the second–
the change in the ego–
but it is clear that the latter has its own ætiology and indeed it must
be admitted that our knowledge of these relations is as yet imperfect.
They are only just becoming the object of analytic investigation. I
think that here the analyst’s interest tends to be quite wrongly
orientated. Instead of inquiring how analysis effects a cure (a point
which in my opinion has been sufficiently elucidated) we should ask
what are the obstacles which this cure encounters.
This brings me to two problems which arise directly out of psycho-
 

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analytic practice, as I hope to show by the following examples. A
certain man, who had himself been a most successful practitioner of
analysis, came to the conclusion that his relations with men as well as
with women–the men who were his rivals and the woman whom he
loved–were not free from neurotic inhibitions, and he therefore had
himself analysed by an analyst whom he believed to be more expert
than himself. This critical exploration of his own personality was
entirely successful. He married the woman whom he loved and
became the friend and teacher of the men whom he had regarded as
rivals. Many years passed, during which his relation to his former
analyst remained unclouded. But then, for no demonstrable external
reason, trouble arose. The man who had been analysed adopted an
antagonistic attitude to his analyst and reproached him for having
neglected to complete the analysis. The analyst, he said, ought to
have known and to have taken account of the fact that a transference-
relation could never be merely positive ; he ought to have considered
the possibilities of a negative transference. The analyst justified
himself by saying that, at the time of the analysis, there was no sign
of a negative transference. But, even supposing that he had failed to
observe some slight indication of it, which was quite possible consider-
ing the limitations of analysis in those early days, it was still doubtful
whether he would have been able to activate a psychic theme or, as
we say, a ‘complex’, by merely indicating it to the patient, so long
as it was not at that moment an actuality to him. Such activation
would certainly have necessitated real unfriendly behaviour on the
analyst’s part. And, besides, every happy relation between analyst
and analysand, during and after analysis, was not to be regarded as
transference. There were friendly relations with a real basis, which
were perfectly compatible with normal life.

I now pass on to my second example, which raises the same problem.
A girl who had left her childhood behind her had, since puberty,
been cut off from life by an inability to walk, owing to acute pain
in her legs. Her condition was obviously hysterical in character
and it had resisted various kinds of treatment. After an analysis
lasting nine months the trouble disappeared and the patient, whose
character was truly sound and estimable, was able once more to
take her place in life. In the years following her recovery she was
consistently unfortunate : there were disasters in her family, they
lost their money and, as she grew older, she saw every hope of happiness
in love and marriage vanish. But this woman, who had formerly

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been an invalid, stood her ground valiantly and in difficult times was
a support to her people. I cannot remember whether it was twelve
or fourteen years after the end of her analysis that she had to undergo
a gynæcological examination on account of profuse hæmorrhages.
A myoma was discovered which made it advisable for complete
hysterectomy to be performed. From the time that this operation
took place she relapsed into neurosis. She fell in love with the surgeon
and was overwhelmed by masochistic phantasies of the dreadful
internal changes which had taken place in her–phantasies in which
she disguised her romance. She proved inaccessible to a further
attempt at analysis, and to the end of her life she remained abnormal.
The successful analytic treatment took place so long ago that we
could not expect too much from it ; it was in the first years of my
work as an analyst. It is, however, possible that the patient’s second
neurosis sprang from the same root as the first, which had been success-
fully overcome, and that it was a different manifestation of repressed
tendencies which analysis had only partially resolved. But I am
inclined to think that, but for the fresh trauma, there would have
been no second outbreak of neurosis.

These two cases, purposely selected from a large number of similar
ones, will suffice to set going a discussion of the problems we are
considering. The sceptical, the optimistic and the ambitious will
draw very different conclusions from them. Sceptics will say that
they prove that even a successful analysis does not prevent the patient
who is cured for the time being from subsequently developing another
neurosis, or even a neurosis springing from the same instinctual root,
that is to say, from a recurrence of his former trouble. The others
will maintain that this is not proved. They will object that both
the cases I have cited date from the early days of analysis, twenty or
thirty years ago. Since then we have acquired deeper insight and
wider knowledge and, in adapting our technique to our new discoveries,
we have modified it in many respects. To-day we may demand and
expect that an analytic cure shall be permanent or, at least, that, if
a patient falls ill again, his fresh neurosis shall not turn out to be a
revival of his earlier instinctual disturbance, manifesting itself in a
new guise. Our experience, they say, is not such that we must limit
so strictly the demands which we may legitimately make upon psycho-
analytic therapy.

Now of course my reason for selecting these particular cases as
illustrations was precisely that they date so far back. It is obvious

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that the more recent the result of an analysis the less valuable is it
for our theoretical discussion since we have no means of predicting
what will happen later to a patient who has been cured. Clearly
the expectations of the optimist presuppose a number of things which
are not exactly a matter of course. In the first place he assumes
that it is really possible to resolve an instinctual conflict (or, more
accurately, a conflict between the ego and an instinct) finally and for
all time. Secondly, that when we are dealing with one such conflict
in a patient, we can, as it were, inoculate him against the possibility
of any other instinctual conflicts in the future. And thirdly, that we
have the power, for purposes of prophylaxis, to stir up a pathogenic
conflict of this sort, when at the moment there is no indication of it,
and that it is wise to do so. I merely suggest these questions: I do
not propose to answer them here. In any case a definite answer is
perhaps not possible at the present time.

Probably some light may be thrown on the subject from the
theoretical standpoint. But already another point has become clear:
if we wish to fulfil the more exacting demands which are now made
upon therapeutic analysis, we shall not regard the shortening of its
duration as either a means or an end.

III

My analytic experience, extending now over several decades, and
the change which has taken place in the nature and mode of my work
encourage me to attempt an answer to the questions before us. In
earlier days I dealt with a larger number of patients, who, as was
natural, wanted to be cured as quickly as possible. Of late years I
have been mainly engaged in training-analyses and I have also had
a relatively small number of patients suffering from acute neuroses,
whose treatment is carried on with longer or shorter intermissions.
In these cases the therapeutic aim is no longer the same as before.
There is no question of shortening the treatment: the object has
been completely to exhaust the possibilities of illness and to bring
about a radical change in the personality.

Of the three factors which, as we have seen, determine the results
of analysis—the effect of traumas, the constitutional strength of the
instincts and the changes in the ego—we are at this point concerned
with the second only: the strength of the instincts. Reflection
immediately suggests a doubt as to whether it is necessary to use the
qualifying adjective ‘constitutional’ (or ‘congenital’). It is true