The ivory tower thing (other than being, for a Freudian, highly satisfyingly phallic) is what you realize is what is necessary.
Cold, abstracted, penetrating theory. The analyst is not there to be your friend. Not there to appeal to your fantasies. Not there to help rationalize, or dillute the quest. Not there to let theory disippate into mumbo jumbo vapour. Not there to get distracted by the particularities of the concrete case. He is only there to find in those particularities what will advance the medical process using known, established theory.
True psychoanalysis isn’t memorized. It is burned into the mind by seeing it work over and over, like a country doctor learns to treat whatever diseases are common in his area. It becomes an instinct, like any craft does. Its postulates begin to appear by themselves in nature, calling out like a timing belt is calling out to be replaced to a trained ear.
Simple, cold theory is what is most resisted, simply because it is what is actually powerful. The repressive mechanism resists it like death.
But, ironically, the rest of the system, and if any of it is still capable of desiring health, does listen to it. It recognizes the truth in it and desires the power it promises. It appreciates the analyst’s loyalty and commitment to truth, despite the thousand little blackmails attempted by the repressive desire.
I don’t expect to saw off a rotting limb and hear exclamations of joy. This is the secret to how a true analyst earns trust. The coldness of it also shows that the analyst is not personally involved in the transformation, no soul debts will need cancelling, nothing there is to be gained but by the patient, except for the satisfaction of having helped someone heal, and the general benefits to humanity of healthy people.
A trauma survivor is already a perennial target for manipulation anyway. Not participating in that exchange is largely what earns the analyst his trust. That’s also the genius of the original set up with the patient facing away. The analyst is an object, like another piece of furniture. The journey is into the subject’s own mind. The analyst has no place being personally involved.
It does require bravery, though. At the end of the day, like Morpheus in The Matrix, all an analyst can do is show the door. In fact, it is probably important that it be done this way. Being imposed on is already the life experience of a trauma survivor, which precicely you are trying to free them from.
Therefore an ivory tower, not a steel bulldozer. Static, stable, immovable. What point can there be in spiting an ivory tower?
The only real question a patient has to ask themselves is: where am I incoherent?