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Dear Sirs,
It seems to me that in his article ‘The attraction of the topographical technique’ Dr Paniagua sets up a ‘straw man’ by suggesting that the topographical technique ‘is a practice that should be laid to rest’. Indeed, Dr Paniagua, in his first clinical vignette, avoids making an oedipal interpretation and does not heed his own advice, which is to focus on the clinical surface and thereby avoid ‘iatrogenic contamination’. Instead, thinking of his patient's competitiveness with his father, Dr Paniagua asks the patient, ‘Where do you think these demands [to be perfect] are coming from?’ I think Dr Paniagua misses an opportunity, at this point early in the analysis, to strengthen the working alliance. By asking the patient where his feeling of being critically examined by another comes from, Dr Paniagua implicitly encourages him to look into his past. Thus the patient moves to past memories, thereby avoiding the surface. On the other hand, judging from the intense affects the patient brought into the analysis at that point, Dr Paniagua's implicit suggestion (that the patient's difficulty lay in the enduring impact of his earlier experiences) was, in fact, more clinically useful. In the second vignette, Dr Paniagua heeds his own advice and brings the patient's attention to what she was saying, rather then directing her attention to Dr Paniagua's internal formulations about penis envy. As he quotes Busch, ‘the analyst should not indulge his own interests while the patients are inhibiting theirs’.
To follow Dr Paniagua's suggestion that analysts today should not use the topographical model would leave psychoanalysis much impoverished. We should have both models as points of reference. In 1923, the same year he developed the structural model, Freud wrote of the topographical model.
one should strive to catch the drift of the patient's unconscious with his own unconscious … in a state of easy and partial attention so as to avoid, so far as possible, reflection and the