Discussion

DR. EZRIEL'S PAPER is a clear statement of the use of the "here and now" situation in psychoanalysis. It is refreshing to have pointed our so lucidly and cogently that the observations in the therapeutic situation are the only real data with which the analyst can work since everything else is necessarily an edited account of past events or speculation. It takes a great deal of rigorous self-discipline for a therapist to hold to the use of the very effective tool of transference as defined in this paper. It is the same discipline that is required in the self-study groups initiated by Wilfred Bion and continued in the Group Relations Conferences sponsored by the Centre for Applied Social Research of the Tavistock Institute of London, the Washington School of Psychiatry in the United States, and certain other institutions.

Like all purists Dr. Ezriel, in my opinion, limits the field unnecessarily and loses sight of the therapeutic value that other approaches have for patients even though they are not based so firmly on hard data. Dr. Ezriel's "laws" are very useful ways of conceptualizing much that occurs in psychoanalysis. At the same time they do not take account of the fact that not all of a patient's behavior is neurotic and does not, therefore, fall into the categories of the three kinds of object relationships he mentions. It does make sense to think of a patient's neurotic behavior as an avoidance of a kind of relationship which he fears because he thinks it will lead to calamity. But in avoiding one kind of relationship, the patient still has an option of many other kinds of relationship. The "required" relationship is thus not completely understandable in terms of avoidance alone. Other factors play a role in bringing about the particular kind of behavior which the patient "chooses" (obviously not as a conscious choice) to replace the repressed.

In spite of these reservations, I find Dr. Ezriel's work a model of an intelligent, scientific approach to th