Some Arguments About Free Association as a Technique.

Freud, early in psychoanalytic history, modified hypnotic technique and recommended, in its stead, free association. This paper takes a close look at the theoretical foundations of that technique in light of theoretical developments over the past hundred plus years. It is argued that free association is similar to an asymptote, which is never quite reached. Moreover, it is argued that the direction to free associate is contraindicated in many, if not most, psychological disturbances. Guided association or avoidance of free association is sometimes required. For a limited group of patients, whose major ego functions (abstraction, integration, and reality testing), ego strengths (impulse control, affect tolerance, and containing primary process), object relations (capacities for empathy, trust, and closeness), and superego (shame/guilt) are intact, the direction to use the couch and attempt to free associate may still be quite useful. For most people who present for treatment, however, this approach is likely not beneficial. The complex arguments about the decision-making process regarding free association are discussed.

A psychoanalytic view of reactions to the coronavirus pandemic in China.

The coronavirus pandemic, which apparently began in Wuhan in December 2019, and has persisted to the present day, has had several psychological effects in China. The real danger has produced prolonged stress. Large-group phenomena have been stimulated. Overwhelming affects generated by the real danger have led to regression in the stimulus barrier (or "filter"). The COVID-19 has also triggered unconscious defensive reactions, including obsessional cleaning, counterphobic behavior, humor, and denial. The nationally imposed home quarantine of millions of families has caused in-home conflicts and neurotic repetitions of unresolved childhood issues. Prior psychiatric illnesses have been exacerbated. Health workers, including psychiatrists, psychologists, and psychoanalysts, have experienced emotional depletion. Finally, in families where there has been infection or death, delayed mourning and post-traumatic phenomena have been observed. In each of these situations, different interventions based on psychoanalytic principles have been useful.