Dr. Clemmens Replies

I did step into a hornet's nest by daring to critically review the papers by Elkind and Abarbanel. Their responses, together with Joyce Lerner's, are certainly spirited, but they are not convincing.

I will address their accusations jointly, since they seem to be of one mind.

Yes, it is true that I have not read Elkind's book. It also is a fact that there are far more books in this world that I have not read than those that I have. Yet I insist that papers that are submitted for publication must stand or fall by their own merit.

The comments by the three writers fall into two categories, the first one being a defense of their collective views, the second one consisting of a variety of attacks against me “ad hominem.”

I do agree with some of the basics, such as the existence of incompetent and otherwise defective therapists. I share the authors' concern about the damage done to patients, and I am as eager as they are in my efforts to heal. It is about the details that we have a parting of the ways. I shall use only one example that is illustrative, i.e., The False Memory Syndrome. To Abarbanel “this controversy is not relevant to this discussion.” To me it is. The patient remembered two incidents of being sexually abused by her grandfather and subsequently she remembered that she and her sisters were sadistically and repeatedly sexually abused by a great aunt and uncle at an even younger age. Such claims by a patient have diagnostic value. A therapist's fear of excessive pathologizing will impair her diagnostic acumen. It is to be deplored, just as its opposite, by which I mean the rigid categorizing of diagnostic entities which is an exercise in therapeutic futility and the bane of contemporary psychiatry.

My position is that intellectual rigor, sobriety, and skepticism are compatible with therapeutic effectiveness. Joining a patient in the misery of his delusional world does not require that we become partners to the excesses of a folie à deux.

I do not know Alice Abarban