The internal separation struggle and therapeutic progress

If psychoanalysis is first and foremost a romance of the familiar, then its simultaneous role as a theory of therapeutic change might appear incongruo us, if not contradictory. Nevertheless, much attention has been paid, in th e years following Freud's death, to the development of a psychoanalytic the ory of the mechanisms of change, although the psychoanalytic study of the a esthetics of change (according to Freud's use of the term, in which "aesthe tics is understood to mean nor merely the theory of beauty but the theory o f the qualities of feeling" [S. Freud, 1919/1955b, p. 219]) has been less t horoughly attended to. It is to this latter sort of psychoanalytic account of change that this article speaks. Specifically, the author inquires into the forms and genesis of one particular aspect of the psychoanalytic aesthe tics of change, which arises when the patient's progress in psychotherapy a rouses a sense that she or he is leaving behind a more disturbed version of herself or himself, for a new and largely unfamiliar one, with intolerable consequences.