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The publication of this short collection of papers, given at a Conference at the Freud Museum in London in 1995, is timely. The need is growing, from within and without the discipline, for clearer descriptions of what goes on in the consulting room. Allied to this are questions about how clinical data can be most effectively communicated and whether comparison and correlation of data can be made possible. The recent discussion in the literature prompted by the Seventy-Fifth Anniversary of the IJPA on the status of clinical facts is very pertinent to the issues discussed in this book. Also raised, of course, is the fundamental conflict between the patient's right to confidentiality and the psychoanalytic community's need for scientific knowledge.
The first paper is by Ronald Britton. Although he states at the outset that he is not primarily writing about the ethical issue of publishing clinical material, he quickly offers the reader the benefit of his experience and thinking on this matter. He of course counsels disguising the material to protect the anonymity of the patient and furthermore he advises obtaining the permission of the patient to publish. He then writes that this does not relieve the author of a sense of guilt: ‘[w]e may feel that we are not betraying a confidence but we are left with a feeling that we are betraying an affiliation’ (pp. 11-12). Britton goes on to state that not to do this can involve the betrayal of another affiliation, that is, to the scientific community of which one is a member. It is wise to address this matter, which will probably be at the forefront of many readers' minds at the beginning of the paper and of the book. Once the impossibility of its easy resolution and the inevitability of struggling with difficult feelings when publishing have been noted, the reader can pursue other issues with interest such as an author's other anxieties about publishing clinical work. Britton is particularly interested in the author's c