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When it comes to using medication in analysis, there is much we do not know and little that is certain. To address the scarcity of research and written reports, Richard Gottlieb organized this panel to highlight current issues in the integration of medication and psychoanalysis. Stephen Purcell, the first presenter, illustrated how enactments develop when medication is prescribed; he ventured that the failure to analyze these enactments can impede psychic growth. Adele Tutter countered that detrimental enactments may occur when analysts withhold the use of medication. She admonished analysts who do not consider pharmacotherapy for some of their patients. Glen Gabbard, in the role of discussant, had comments both in support of and against these points of view. He recommended that analysts remain open-minded and not treat medication as an inferior option. During the question and answer period, the audience remained curious as to how to integrate thinking about medication into an analytic framework. Perhaps the most insistent question was, Does an analytic sensibility lead one away from medicating? Implicit in the proceedings was the search for a prevailing theory that integrates these two modes of thinking.
Gottlieb's introduction sounded the ambivalent bell that was to ring throughout the afternoon. Acknowledging that the use of medication in psychoanalysis is largely accepted by the psychoanalytic community, he nonetheless went on to remind the audience of several reports in the media about the overmedication of children and the finding that some negative outcome studies on medication may have been suppressed by pharmaceutical companies.
A major theme in his remarks, one that reverberated in all that followed, was the dichotomy of symptom relief / context of symptom. While the psychiatric profession could point to the DSM as a guide to treatment,