You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Otto Kernberg's very stimulating paper addresses the issue of the differences between psychoanalysis and psychotherapy, principally within three parameters, conceptual, clinical and pedagogical. He rightly points out that there is a significant political aspect to this question, particularly in regard to the relationship between psychoanalytic societies and psychotherapy association, but purposely leaves this to one side in order to focus in greater depth on the theoretical and clinical issues.
He comments that in French psychoanalysis the differences between psychoanalysis and psychotherapy seem to be more difficult to ascertain and suggests this has called into question the identity of the psychoanalyst.
In my view in French psychoanalysis it is strongly apparent that there are theoretical and clinical differences between psychoanalysis and psychotherapy and in this contribution I shall address this matter from the viewpoint of the theory of the analytic process.
We need a concept of a unified analytic process that obtains for all the different treatment modalities. This unity of the analytic process is based on the conception of mental functioning formulated by Freud on the model of the baby's experience of satisfaction at the breast. As we know, this is a postulate based on the dream experience and unverifiable by experiment, according to which hallucination is satisfaction.
In this view, instinctual excitation is the source of an automatic anxiety, and its binding with representations (thing-and word-presentations) allows the transformation of this automatic anxiety into an anxiety that is a signal of alarm and the transition from a tendency towards absolute discharge to the pleasure of fantasy and thinking.
The model of mental functioning based on the importance of a binding of excitation in representations, thus of a process of representation and symbolisation, determines the objectives of the treatment and the techniques used, as well as the indications and contr