ABSTRACT
The unconscious is timeless. The ways in which patients present may alter over time - for instance, classic conversion hysteria seems to have given way to medically unexplained symptoms and psychosomatic disorders - but people's underlying conflicts and emotional difficulties probably remain much the same. Suppose that for a period a therapist remains relatively silent, working on the principle that free association may be most effective for exploring and coming to understand a person's underlying state of mind. In the present climate, this represents a stark deviation from what a patient expects, and from what many patients feel entitled to expect. There have been other, related shifts in perspective. The psychotherapy market place has become crowded with a plethora of technical approaches. Mostly, these focus on what can be articulated and rendered explicit. Of course, being concerned with symptom alleviation is not at all incompatible with seeking after depth of understanding.
