Here is an example offered by Reich (1972, p. 80) regarding how the transition takes place from addressing the transference to addressing the underlying neurotic issues.

. . . .[A] patient never becomes emotionally involved and remains indifferent, regardless of what material he produces, one is dealing with a dangerous emotional block, the analysis of which must take precedence over everything else if one does not want to run the risk of having all the material and interpretations lost. If this is the case, the patient may acquire a good knowledge of psychoanalytic theory, but he wi11 not be cured. If, confronted with such a block, the analyst elects not to give up the analysis because of the “strong narcissism,” he can make an agreement with the patient. The patient will be given the option to terminate the analysis at any time; in turn, he will allow the analyst to dwell upon his emotional lameness until it is eliminated.

For Reich (1972, p.80-81), this is not a short-term process. He would never have subscribed to the present-day emphasis on short-term therapy.

Eventually it usually takes many months (in one case it took a year and a half) the patient begins to buckle under the continual stressing of his emotional lameness and its causes. In the meantime, the analyst will gradually have obtained sufficient clues to undermine the defense against anxiety, which is what an emotional block is. Finally, the patient rebels against the threat of the analysis, rebels against the threat to his protective psychic armor, of being put at the mercy of his drives, particularly his aggressive drives. By rebelling against this “non-sense.” However, his aggressiveness is aroused and it is not long before the first emotional outbreak ensues (i.e., a negative transference) m the form of a paroxysm of hate. If the analyst succeeds in getting this far, the contest has been won. When the aggressive impulses have been brought into the open, the emotional block has been penetrated and the patient is capable of analysis. From this point on, the analysis runs its usual course. The difficulty consists in drawing out the aggressiveness.

It would seem that the Armor is not just being oiled—it is also being beaten on by the analyst. The thumping might reveal a wounded heart; it certainly will arouse a reaction from the patient—and this helps to “break the emotional block” (that is the psychic armor).

Addressing the Neurotic Symptoms

How then are the neurotic symptoms confronted? It is often the case that Reich (1972, p. 89) focuses on the patient’s anxiety—for this anxiety often is directly associated with the underlying neurosis. Furthermore, the anxiety often impacts in an immediate way on the patient’s daily life—thus providing a motive for delving deeply into the conditions that precipitate this anxiety:

The patient’s attacks of anxiety were accompanied by palpitations and a paralysis of all volition. Even in the intervals between these attacks he was never wholly free of a feeling of uneasiness. Frequently, the attacks of anxiety occurred quite suddenly, but they were also easily provoked when, for example, he read about mental illnesses or suicide in the newspaper. In the course of the previous year his work capacity had shown marked signs of deteriorating, and he feared that he might lose his job because of his reduced performance.

We find in this brief description of one patient’s experience of anxiety a clear example of what Robert Sapolsky (1998) describes in our previous essay as a state of Freeze. When we are frozen in anxiety, imagining many threatening lions, there is little opportunity to perform our job—or as Reich often suggested—establish satisfactory interpersonal relationships or a gratifying sex life.