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Malin, B.D. (1998). Epilogue. Psychoanal. Inq., 18:746-762.

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(1998). Psychoanalytic Inquiry, 18:746-762

Epilogue

Barnet D. Malin, M.D.

Daughter: Daddy, what is an instinct?

Father: An instinct, my dear, is an explanatory principle.

D: But what does it explain?

F: Anything—almost anything at all. Anything you want it to explain.

From “Metalogue: What Is an Instinct?” in Steps to an Ecology of Mind, Gregory Bateson, 1972, p. 38.

Why is studying the relationship between psychoanalysis and psychopharmacology so difficult? Several decades ago, the explanatory principles of psychoanalytic ego psychology structured the issue relatively clearly: psychotropic medications interfere with the psychoanalytic process because they alter symptoms that, as the products of neurotic defenses against drive derivatives, serve as motivation for transference and treatment. This point of view generated fantasies of all sorts that still haunt the shadows of our literature on the subject. Using psychotropic medications in an analysis can feel like committing a dirty, secret act evoking mixtures of shame and hope. Presc

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