Comments and Criticisms

Dr. Stern replies:

MS. ORTMEYER'S CHARGE that I essentially recycled an earlier chapter with only minor modifications is a serious one; thus I appreciate this opportunity to respond.

I was obviously aware of the points of overlap between my earlier chapter and the Contemporary Psychoanalysis article. I therefore made reference to the former publication immediately, in the first footnote. I am confused by Ms. Ortmeyer's statement that I do "not cite the book" containing the earlier chapter. The book is listed in the reference section, but (due to a proofreading oversight on my part) under the title and expected publication date that were current at the time I first submitted the paper to Contemporary Psychoanalysis. (I note that Ms. Ortmeyer also cites the date incorrectly in her letter.) If she meant that I should have named the chapter and book in the footnote itself, I tend to agree. However, it was not my intention to downplay the relationship between the two pieces.

I disagree with Ms. Ortmeyer's characterization of the Contemporary paper as "slightly reworked." While the basic concept of "opposing currents" and the clinical case material illustrating it are indeed (for the most part) the same, the theoretical framework for understanding the technique's efficacy (constituting 12 of the paper's 19 pages of text) is almost entirely new. The earlier chapter was primarily clinical, written for an audience with a specialized interest in the psychodynamic treatment of eating disorders. The application of the opposing currents idea to work with eating disordered patients was original in that paper, but the theoretical section was brief and, from my current perspective, somewhat "primitive." The second paper was written in consequence of my more recent immersion in a variety of psychoanalytic ideas and represents a significant evolution in my thinking. It also aims to connect the opposing currents approach with certain theoretical issues and controversies in the