Editorial

Getting down to the nitty-gritty of the dilemma of the would-be psychotherapy patient is the task of clinical assessment: that is, getting a feel for the internal state of the object relations and the external problems in the person's life situation. Then comes the testing of the person's capacity for withstanding the rigours of the interpretive process, the strength of the personality to own and to bear the disturbing emotions that emerge on the road to insight and change. The first programme of the BBC TV series The Talking Cure presented a rare chance to view this process in Caroline Garland's assessment at the Tavistock Clinic of the suitability of a young man for pychodynamic psychotherapy. In our Special Clinical Commentary we print the responses of three clinicians to the interviews, which bring up the important question of how much can and should be done in the initial assessment sessions.

How does the patient know, how can she/he trust, that the therapist will be able to contain and to alleviate the pain of the failure of previous object relations? Required for this kind of trust are not only the initial leap of faith propelling the patient into therapy, but also actual experiences of relief gained from the beginning and from the ongoing nature of the therapeutic relationship as trust grows. More than relief from pain, the integration, development and growth of the personality are desired and conceptualized in different ways in the psychoanalytic literature. Gabriela Mann's article in this issue discusses Christopher Bollas's concept of the functioning of the therapist as a ‘transformational object’, based on the care given to the infant by the ‘environmental mother’. It is this transformational function of the analyst and the setting that fosters a generative or creative environment of internal associations and ultimately alters the traumatized self. Mann brings in by way of contrast two of Bollas's analytic objects that defensively ‘conserve’ or ‘terminate