The British Journal of Psychiatry
Prokaletic Measures Derived from Psychoanalytic Technique


Freud's psychoanalytic technique takes as its main target transference manifestations which resist the progress of treatment. By interpreting the unconscious, and therefore shocking, psychogenesis of these manifestations, the patients are challenged to counteract them as much as possible. The term "prokaletic" has been introduced as a synonym of the term "challenging".

Using Freud's psychoanalytic technique as a model, prokaletic measures have been elaborated. They have proved successful especially with conversion-hysterical symptoms, therapeutic resistances, certain self-indulgent practices, and some obsessional symptoms. Caution is needed with severely depressed patients, who may respond with aggravated guilt feelings and increased suicidal urges. The main prokaletic measures are challenging interpretations, and admissions and predictions of therapeutic failure. Guiding interpretations, reassurance and appreciative remarks are also employed and are if necessary combined with chemotherapy and electroshock treatment.