Clinical Commentary

(In this section a short piece of clinical material from an actual session is presented with a brief introduction about the case. The material as published here was sent ‘blind’ to two people who represent different psychotherapeutic schools of thought. They have been asked to comment on the material and the approach of the therapist in the session. The intention in putting these commentaries side by side is to compare the approaches of the different schools in order to facilitate the understanding of alternative terminologies and modes of practice).

The therapist writes:

The Patients Personal Background

The patient is a 29 nine year old man, divorced and now involved with a woman who is in England for a limited period of time taking a course. He is highly successful in a difficult profession and his present job and workplace are particularly competitive and emotionally bruising.

He was born abroad and when his parents returned to England he was seven years old. His personal care reverted abruptly back to his mother from servants. He remembers the transition as one from relative indulgence to a noticeably stricter regime. From this time on he had a repetitive dream in which he was searching in busy streets for his parents, spotted them, chased them, finally caught up with the couple who turned and revealed they were strangers.

At first his father was the bete noir in therapy, described as puritanical, moralistic and harsh. But it soon seemed, to me at least, that while he was at least involved with the patient, the mother was not. The patient described his mother's care as cold and mechanical. However he is in the present much involved with her and visits her regularly. His father died some years ago. He has one sibling.

In therapy he described attacks and injuries to his self esteem in childhood. These took the form of teasing by other boys which left him undermined. He later wondered whether he really had been teased so badly, or whether great har