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As the title of this book indicates, Peter Lomas thinks that there is something wrong with the way that psychoanalysts conduct psychoanalysis. And he goes on to ask some interesting philosophical questions about the nature of the analytic enterprise: ‘What do we mean when we say an interpretation is true?’ and ‘Can a psychotherapist manage without a theory?’. However his answers to these questions seem less satisfactory. He begins by saying that ‘we cannot help seeking to influence others in favour of our dearest beliefs, but we can try and limit this influence and be aware of the subtle ways in which it is achieved’. This position leads him on to suggest ways in which we can try to lessen this influence. He is critical of Freudian theory for he believes it perpetuates a paternalistic power struggle, while at the same time he thinks that ‘the place of Freudian interpretation in therapy with patients is more limited in scope than psychoanalysts maintain’. His view is that ‘the business of helping patients has much more in common with ordinary living than is usually thought’. He gives some clinical vignettes of this ordinary living with patients. He cites a case in which a timid patient asks if she can use his lavatory and he replies, ‘Yes, of course’. He says, ‘My answer was designed to enable someone very unsure of herself, to feel her behaviour was acceptable. By contrast an interpretation might have made her feel criticised’. Another example he gives is of a patient who arrives ten minutes before the end of the first session after the summer break. ‘This will have to be a social visit’ she says, to which Lomas responds by telling her about his holiday. He later reflects that this spontaneous response led him to recalling some painful memories of his own, and to the thought that ‘had I responded to her in the light of my theory-based ideal about her resistance to me by immediately making an issue of her lateness something valuable might have been lost’.
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