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ON THE BEGINNING OF TREATMENT (138-40)
Sigmund Freud (1913)

Summary:
At the beginning of psychoanalytic treatment, we encounter patients who claim to have nothing to share, despite having a
complete life and history of illness
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This initial
resistance is evidence of the defense that the neurosis exerts over them
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Patients who start out this way are usually prepared to explore intense sexual or emotional topics
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For example, a patient with refined aesthetics may
reveal previous behaviors related to coprophilia, while another may exhibit narcissistic pride in their physical appearance
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In addition, many patients prefer to modify the traditional position of the analysis to maintain a more visible interaction with the
doctor
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However, it
is essential to break this separation and address the resistances that try to maintain this division
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Before introducing in -depth interpretations and
analytical techniques, it is necessary to establish a strong therapeutic relationship
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Explanation and conclusion:
This text highlights the challenges we face at the beginning of psychoanalytic treatment when patients may resist participating in
the therapeutic process
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Instead, it is crucial to confront this resistance firmly
to allow access to analysis
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In
addition, it highlights the importance of paying attention to the patient's initial actions and symptoms, as they can reveal important
underlying complexes that need to be addressed in the analysis
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This can result in a separation between the "official" and "informal" moments of treatment,
which must be overcome to promote more genuine and effective communication
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It is essential to establish a
solid therapeutic relationship before introducing in-depth interpretations and analytical techniques
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In conclusion, the text highlights the importance of firmly confronting the initial resistance of patients and establishing a solid
therapeutic relationship before delving into the analysis of transference and other more complex aspects of psychoanalytic
psychotherapy
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- Do not give in to patients' requests on what topics to address, initial resistance as a defense of neurosis
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- Patients who start out this way are often ready to explore intense topics such as sexual or emotional
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- Examples include disclosures of previous behaviors such as coprophilia or narcissism
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- This modification may divide the treatment into "official" and "informal" moments
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- Transfer should not be addressed until it becomes an operational resistance
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- Only then can the deeper meaning of patient interactions be explored and the resistances that have arisen in the
process addressed

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