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In the first part of this paper I shall describe my reflections during the conference and in the second part will develop these further.
Joseph Sandler, in his paper on problems of differentiation, expressed his view that there is a real difference between therapy and analysis but that there is no simple way of differentiating them. He suggested that there is no one criterion nor indeed one set of criteria, necessary and sufficient to differentiate analysis and therapy. If analysis is defined as being what analysts do then the problem becomes one of defining what an analyst is, and since analytic training varies from country to country this cannot be on the basis solely of training.
This seemed to me something that could be thought about both as a problem in philosophy and as a clinical problem. In philosophy, if there is an apparently intractable problem then one approach is to consider whether the question is in fact a pseudo-question. It may, that is, have the form of a question but be incoherent or meaningless, as in ‘How large is the mind?’. It may be susceptible of reformulation into a real question, or examination of the premises may lead to the conclusion that they do not support the question at least in that form.
If in the clinical field one is presented by a patient with an apparently insoluble problem, then one tends to think that something from the inner world is being projected onto the situation for defensive reasons. ‘The hedonic gain is obvious if conflicting attitudes to the same thing at the same time can be replaced by different attitudes to different things at different times’ as Money-Kyrle remarks (1978).
I wondered therefore why the problems to do with differentiating psychotherapy and psychoanalysis seem to be intractable, at least in the sense that no straightforward answer has been arrived at. What is being projected here, what is the underlying anxiety, and what would constitute reality testing could the projection be withd