ABSTRACT
Psychoanalysis was cultivated in the bed of medicine and took shape out of the effort to treat a disorder, hysteria, that hovered between the somatic and the psychological. For this group of patients, hysterics, the medical model seemed appropriate. As the practice of psychoanalysis gained in reputation, however, it began to attract a broader class of patients, patients whose suffering was less clearly demarcated. Now the field began to trespass on territory that had belonged to religious and moral disciplines. The impetus for change in psychoanalysis during this period was spurred on by analysts’ encounters with these patients. Analysts began to work with patients who were simply unhappy or who suffered from deficits in self-esteem, with children and with psychotics. These patients, while widely different in presentation, all required a more engaged mode of contact with their analyst, and put pressure on the field to refine the theoretical underpinnings of analysis.
