Commentary by a Psychoanalytic Psychotherapist

On the unusual, even rare, occasion when psychotherapists have the opportunity to view directly another psychotherapist at work, there is an inevitable sense of fascination and privilege. Then, after becoming immersed, one has a more complex response: how to think about the colleague's work when the theoretical orientation or personal style may or, perhaps just as problematic, may not differ from one's own. In the assessment interviews conducted by Caroline Garland at the Tavistock Trauma Clinic, presented on the BBC programme The Talking Cure, we had an invaluable opportunity to witness the working of a highly-trained analytic mind in interaction with a troubled, psychotherapeutically inexperienced young man. Any evaluation of the interviews will require a careful attempt to understand what the clinical exchanges meant, to tease out the psychodynamic theories on which they were based, and to determine whether the assessment was successful in achieving its aims.

The patient is Jan, 30 years old, who sought treatment for a trauma which occurred at age 21 when he was driving a car at excessive speed and hit another car that pulled out onto the road, killing the other driver. Since the crash Jan has experienced little affect related to the accident and a generalized emotional block. Jan trained as an electrical engineer, but at the time of the assessment he was unemployed, living with his Australian partner with whom he intended opening a coffee shop/art gallery. He spent his time painting and listening to music. A significant situation from Jan's background was given from his application form: his parents divorced when he was 12 and afterwards his father left the family. Jan didn't see his father again until he was 20, and then only briefly. Further information given was that he engages in self-destructive behaviour, smokes cannabis, confuses sex with affection and is trying to become a Buddhist.