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In selecting the theme 'Clinical Issues in Psychoanalysis', for the thirty-first Congress of the International Psychoanalytic Association, the Programme Committee may well have been responding to the implicit challenge posed by Anna Freud (1976) in her address to the London Congress four years ago. After briefly reviewing earlier concerns and triumphs of psychoanalysis she stated that, more recently, 'the history of psychoanalysis is dominated by two efforts: (1) to deny, even in the face of evidence to the contrary, that analytic understanding reaches further than analytic therapy; (2) to restore by whatever means the former unity between exploration and cure'. While the ultimate clinical issues, the issues of cure, and of the efficacy of psychoanalysis as a therapeutic modality cannot be discussed in isolation from theoretical propositions, the participants in this Congress adhered rather closely to its theme. Theory was quite consistently and directly related to clinical issues and what emerged was a careful and comprehensive evaluation of psychoanalysis as a clinical discipline, and of our work as psychoanalysts.
Clinical issues occupy a special position in our field. On the one hand they are first order derivatives of the observations which we make in our daily work; on the other they constitute the immediate base for theory formation. Thus, their intermediate position between observation and theory permits them to serve as a bridge, linking the two. This linkage, and its corollary, the linkage between understanding and cure, are the hallmarks of psychoanalysis, which distinguish it from all other forms of treatment for mental disorder. While almost all of us agree with Anna Freud that analytic understanding reaches further than analytic cure, the focus on clinical issues at this Congress constituted a constructive effort towards narrowing the gap between the two.
The theme, 'clinical issues', may be paraphrased, somewhat less diplomatically, 'clinical pr