Commentary by a Kleinian Therapist

This 40-minute tape, shown publicly, has a number of purposes: to demonstrate, and argue for, the benefit of psychotherapy; to publicize the Tavistock Clinic, and to announce the work of the Trauma Unit. In addition, no doubt, the programme makers wished to capture audience share. Such a catalogue of aims inevitably leads to conflicts, which are dealt with by various methods.

Since the purpose of this commentary (to illustrate a point of view - Kleinian) is not one of the aims of the programme, a commentary is disadvantaged. Nevertheless, I think that there is enough ‘material’ that inevitably bursts through to take a view.

The programme followed a particular course, one restricted to the content of the patient's communications. It reveals deeper, implicit and unconscious meanings. This is in line with the more cognitive view of interpretation typical of the early days of psychoanalysis. Because it is a more familiar approach the programme-makers, I imagine, relied on it to present ‘the impenetrable ideas of psychoanalysis’ to the uninitiated.

But there are moments when one can get some inkling of a second approach. That follows the process of interaction, the transference/countertransference that is going on between patient and therapist. The latter approach depends heavily on sequences of dialogue between patient and therapist, and, because of editing, these are not often available here.

Psychoanalytic psychotherapy today will attend to both approaches, and picks up where the pattern in one perspective matches the pattern in the other - a binocular view which will point to the eventual interpretation. I shall take these approaches separately and start with the first, the unconscious meanings of the contents of the patient's thoughts.

The patient was referred initially by his GP to the Trauma Unit, and the programme records an assessment process of four sessions. Interestingly, the actual trauma - the death of the ‘other driver’ in a ro