Reflections on the Future Development of Self Psychology
In the chapter, "The Psychotherapy of Hysteria," in Studies on Hysteria (1895), which he wrote together with Breuer, Freud writes:
When I have promised my patients help or improvement by means of a cathartic treatment I have often been faced by this objection: "Why, you tell me yourself that my illness is probably connected with my circumstances and the events of my life. You cannot alter these in any way. How do you propose to help me, then?" And I have been able to make this reply: "No doubt fate would find it easier than I do to relieve you of your illness. But you will be able to convince yourself that much will be gained if we succeed in transforming your hysterical misery into common unhappiness. With a mental life that has been restored to health you will be better armed against that unhappiness." (p. 305)
In a touching letter to the mother of a homosexual asking Freud to cure her son of his love tendencies, we find an identical fundamental quality:
By asking me if I can help, you mean, I suppose, if I can abolish homosexuality and make normal heterosexuality take its place. The answer is in a general way, we cannot promise to achieve it. In a certain number of cases we succeed in developing the blighted germs of heterosexual tendencies which are present in every homosexual, in the majority of cases it is no more possible. It is a question of the quality and the age of the individual. The result of treatment cannot be predicted.