‘Memory and therapeutic action’

Dear Sir,

Although Peter Fonagy's editorial on ‘Memory and therapeutic action’ deserves a detailed and careful rebuttal, it seems wise to quickly go on record as finding it both poorly referenced with some authors noted but somehow lost in the bibliography (Squire, Pillemer & White), as well as it stating some clearly erroneous facts.

Procedural memory is but one category of memory and is felt to play no role whatsoever in autobiographical memory (Nelson, 1996). However, most analysts do study patient biographies and autobiographies. Katherine Nelson has carefully reviewed the literature on autobiographical memory and has concluded that it is a distinct form of episodic memory. In truth procedural memory is only demonstrable in Alzheimer patients, and it is there that one can see how episodic memory is lost in the typical amnesia syndrome. Perhaps Fonagy is confusing procedures such as riding a bicycle with meaningful action which is part of semantic memory.

Whatever way memory is categorised, there is no logic in leaping to the claim that treatment is based on ‘a way of experiencing the other’. Fonagy has confused the distributed representation seen in connectionist systems, which seem to suggest that one cannot pinpoint specific moments of recall, with his own quite idiosyncratic version of procedural memory. At one point he insists that analysts are concerned with autobiographical memory (p. 216) but somehow collapses this fact into procedures (p. 218). This seems both contradictory and a form of special pleading.

There is little doubt that some patients do seem helped by some active emotional experience with the analyst, some by gaining insight into their present behaviour, some by reconstructing the past and some by nothing that we seem to do. Statements such as ‘psychoanalysis is the active construction of a new way of experiencing self with other’ hearken back to Carl Rogers who said exactly the same thing (Patterson, 1966, p. 417). I personally find it unfortuna