Editorial

Like mathematics, or science, psycho-analytic psychotherapy can be pure or applied. But, can we ask: how pure is pure? And when is it so impure that it isn't it at all?

There is no doubt that Ruth Barnett's reflections on psychotherapy twice or threetimes a week strike a cord. Frequency is important, but what importance and how important? These questions affect psychotherapists. A good deal of status for the therapist may often attach to how near to the psycho-analytic five-times-a-week he works. Nevertheless, as Ruth Barnett says, the frequency of sessions significantly affects patients - though perhaps in different ways. There is often a need to tailor the frequency to the patient. More equals more intense, equals better, does not necessarily apply. The theme is taken up by Anthony Ryle and his colleagues who have been venturing into a new, and integrative, world by alloying cognitive therapy with some central aspects of psycho-analytic theory and practice - to form a ‘cognitive-analytic therapy’ (in contrast to cognitive behavioural therapy). They claim that such a blend allows a shortening of the duration of therapy, and argue strongly for the need for such time-limited methods in the hard-pressed public services.

Linda Hoag also writes about an unconventional adaptation of psychotherapy - to therapeutic work in a general practice. Counselling and psychotherapy in general practices is rapidly becoming less unconventional; more and more therapists and counsellors are being taken on by doctors. Necessarily there is a need for increasing attention to this form of activity. Linda Hoag is concerned with the extraneous pressures which intrude on the work in the medical surgery. Because of the high pressure of medical anxieties and work loads, there are special difficulties in creating a place of safety. Linda Hoag describes the work inherent in holding to a standard and consistent frame or setting for the work. There is also an added spin-off from this work in terms of