In this section, the author responds to Dr Michels's commentary. In contrast to the situation in the United States, there are far fewer psychoanalysts in the UK and very few indeed working in general psychiatry to influence its practice. It is argued that psychoanalysis differs from all other psychological approaches with its recognition of the inner world and

its unconscious influence on the individual's everyday life. Michels invites one to focus on outcome studies to judge the effectiveness of psychoanalysis in schizophrenia. There is a danger of throwing the baby out with the bathwater in that psychoanalysis helps in understanding presenting clinical material and in risk assessment in everyday general psychiatry