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Dear Sirs,
Jane Milton's (2001) article on the differences between psychoanalysis and cognitive-behaviour therapy contains rich insights into the therapeutic situation. Most importantly, by comparing psychoanalysis to a different approach, it addresses a vital issue for our field: the identity of psychoanalysis, especially significant today when rapid changes and, at times, paradigm shifts make the border between one technique and another more and more obscure. Furthermore, as is well known, psychoanalysis as a unified body of theory and practice does not exist, if it ever existed, and we see the flourishing of many ‘psychoanalyses’ to the point that at times the difference between a psychoanalytic and a non-psychoanalytic approach is no greater than the difference between two approaches that are considered under the common psychoanalytic umbrella. And, as Milton correctly points out, the picture is complicated by economical and social pressures. At any rate, in defining which type of psychoanalysis we practise and how we theorise it, a good exercise is to see not only what it is, but also what it is not (in a sort of ‘negative dialectics’), i.e. try to compare it with a (supposedly) different approach—and this is one of the merits of her paper.
Many of Milton's points I agree with, and I want to mention some of them. For example, the current enthusiasm around cognitive-behaviour therapy reminds us of the ‘early idealisation of psychoanalysis, and may prove relatively short-lived’ (p. 431; see also, in this regard, the interesting comments on empirical research, at the end of her paper). As a matter of fact, many cognitive-behaviour therapists, who traditionally worked with mono-symptomatic or ‘neurotic’ patients, now seem to show more prudent attitudes when they are challenged by the treatment of personality disorders: here some of them necessarily rediscover the usefulness of concepts such as transference, countertransference, resistance, even of the need of long-te