Guest editorial

Dear Sir,

I am responding to Donald B. Spence's Guest Editorial (79, 4: 643-647), which concerned my paper ‘The role of working through in bringing about psychoanalytic change’ (78, 3: 469-484). First, let me say that it is nice that someone read my paper, gave it careful thought, and chose to write a commentary about it. I am sure that all authors of published articles see the psychoanalytic literature as a debate in which views are exchanged, and that one's article stimulates discussion is one of the rewards of participating in it.

I am familiar with Dr Spence's ideas, and recognize them in his editorial. I share his skepticism about the written case report or clinical case vignette, although I also believe that they are an important and useful tool in our scientific debate, historically and currently, flawed and imperfect as they are. The psychoanalytic encounter is inherently messy and complex. The participants are consciously aware of only a small part of what is transpiring at any moment, and this is multiplied exponentially when trying to conceptualize the totality of a process that has gone on for hundreds of hours over many years. What the participants do perceive they perceive through glasses that, like an amusement park's fun-house mirrors, impose a unique and individual shape upon what is perceived. What is remembered is doubly altered as the process of recall itself adds a second layer of re-editing to what was perceived subjectively in the first place. That, I am sure, is common knowledge to all thoughtful psychoanaysts. Perhaps the temptation to cling to theories and seek reconfirmation of them in the clinical data is a way of dealing with the anxiety caused by this very messiness.

However, the fact is that in the real world, that is how we do what we do, and it seems to me that we cannot let that deter us from trying, as best we can, to step back from our work, examine it, and try to find language and concepts that allow us to think and write about our