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The development of short-term dynamic psychotherapies since the early 1960's has provided new opportunities to examine the status of psychodynamic theories and to look at their scientific and practical merit - or lack of it.
Useful theories should provide predictions which can be shown to be accurate or inaccurate. Often, in clinical science, the accuracy has to be assessed by some statistical method. But such methods are merely technical tools for certain situations and are not of themselves the sine qua non of scientific technology. Basic science is about making observations and formulating rules. The validity of the rules is demonstrated by the accuracy with which future observations can be predicted.
I hope to show that this basic scientific activity is an essential ingredient in brief psychotherapy. I shall use the case of the Angry Executive to illustrate the way in which the formulation of a treatment strategy depends on formulating predictions which are then tested by observing the response to interpretation. From this viewpoint interpretations are the experimental interventions which should have predictable results if the theoretical basis underlying their formulation is sound.
The Case of the Angry Executive. An executive in his mid 30's consulted me because he felt confused, was having difficulties making decisions at work and had become bad tempered and intolerant. As he was the Sales Director of a British subsidiary of an American company, his job was to some extent at risk. He had tried tranquillisers and sleeping tablets and until recently had been drinking a bottle of spirits a day. His colleagues at work, he said, had been helpful but he had recently had to leave home because of his rage, his wife could no longer stand his outbursts of bad temper. Subsequently, when visiting home he would suddenly “snap” and become enraged. He said that he had no idea what it was that he got so angry about, but he found his work, his wife and his children intolerable.