First Day

Following a brief welcome by Hansi Kennedy, the meeting opened with a paper by the first chairman, Dr Sam Abrams

S. Abrams: My introduction is intended to serve two functions. One is to establish some continuity with past meetings here and the second is to propose a loose framework for engaging this meeting.

This year's topic has to do with how people get better. The topic can be usefully approached within a framework bordered by five issues: (1) being well; (2) becoming sick; (3) getting better; (4) the vehicle for getting better; and (5) actualizing the vehicle. In psychoanalysis we know these issues respectively as: ‘the concept of normality’ - that is, being well; ‘the theories of pathogenesis’ - becoming sick; ‘the mechanism of therapeutic action’ - getting better; ‘the therapeutic process’ - the conveyor of the mechanism; and finally ‘the treatment-relationship contract’ - that which actualizes the vehicle.

The title of this weekend's Colloquium obliges us to focus upon the fourth of these five issues: the therapeutic process, the vehicle for conveying therapeutic action. However each issue is so inextricably linked with the others that it is never possible to discuss any one in isolation as the papers that have been distributed in advance of the meeting bear witness. It is regrettable that this is true, because the psychoanalytic theories of mind, pathogenesis, treatment action, process and contract are vast, complex, ambiguous and even controversial.

It was not always the case. Contrast the contemporary turbulence with the elegant simplicity with which these five issues were addressed in the 1890s. A hundred years ago Freud viewed mind as rising and falling titres of mental energies. He understood pathogenesis as the accumulation of libidinal excesses arising from childhood seduction. Therapeutic action, therefore, necessitated the discharge of the resident unwelcome cathectic abscess. The treatment process was conceptualized as marshalling the