ABSTRACT
However, before discussing change in psychoanalysis, I want to point up a paradox - that in two important ways there has actually not been much change. From the beginning, changes have been limited to progress along the same line, spelled out in Studies on Hysteria (Breuer and Freud, 1893-1895), where Freud delineated the general sequence: (1) a trauma, consisting of the "patient's ego" being approached by an incompatible idea; (2) an arousal of distressing affects by the trauma; (3) a reaction of psychological defense by the patient; and (4) a repetition of that sequence in successive episodes of the illness . It is my view that the progressive elucidation of the details of that schema has been the chief concern in the history of psychoanalytic psychopathology, and continues to be the challenge today .
