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Dear Sir,
Peter Fonagy in his interesting Guest Editorial entitled ‘Memory and therapeutic action’ (Int. J. Psychoanal., 80:215-23) emphasised the important role of implicit or procedural memory for therapeutic change in psychoanalysis. In particular, he stated:
What about dramatic improvement associated with the ‘recovery’ of particular ideas? Here I would claim that recovery (in the sense of therapeutic change) has already taken place, for example, in the sense of being able to see the internal or external world in a somewhat different way and the recovery of a so far unremembered idea is a consequence rather than the cause of a more balanced world view (p. 219).
The fact that often insight is not the prerequisite of change, but rather the consequence of a positive experience in a significant relationship such as the therapeutic one, was observed by Franz Alexander seventy years ago, and was re-emphasised later by him, almost with the same words, when he proposed the concept of ‘corrective emotional experience’. Alexander wrote:
The belief that the recovery of memory is, in itself, one of the most important therapeutic factors, is still held by many psychoanalysts and in a sense can be considered to be a residue of the period of cathartic hypnosis. The persistent emphasis upon intellectual reconstructions of memory gaps can possibly be traced back to the relatively short period of waking suggestion; but it was the still greater emphasis during the free association phase on the intellectual understanding of the past that made psychoanalytic treatment almost synonymous with genetic research. As a result, the filling in of memory gaps became crystallized as the therapeutic goal of psychoanalysis. This exaggerated emphasis has long hampered both the understanding of why patients remember repressed events and the correct evaluation of their therapeutic significance. It was not until 1930 [Alexander, 1930] that the recovery of memories was demonstrated to be not the cause o