Cognitive Repair in the Treatment of the Neuroses

While there is little debate about the importance of cognition to psychoanalysis, there are considerable differences of opinion as to the place that cognition has in theory and therapy. In a number of previous communications, I have maintained that the central dynamics of neurotic living are cognitive, and I have urged a more direct focus on epistemic issues in both theory and treatment. From this perspective, the major task of psychoanalytic treatment is viewed as a process I have called cognitive repair (Barnett, 1966b, 1971b, 1978).

There has been a growing interest in the accumulating knowledge about cognition by psychoanalysis and other psychotherapies. Widely differing orientations now take explicit note of these phenomena and attempt to use them in their theories of therapy in characteristically different ways. My own approach has been psychoanalytic, i.e., it is historical and developmental and assumes that past experience molds meaning, defines intentionality and motivation, and determines the person's mental and behavioral operations with the environment and with the self. Additionally, my orientation towards cognition derives from and extends interpersonal theory (Sullivan, 1953) and therefore shares with other post-Freudian approaches a rejection of libido theory.

Libido theory has fostered a relative neglect of central issues in the psychoanalytic study of cognition by its implications and structure. First, it is apparent that a drive psychology, by its very nature, must ultimately define motivation, and, consequently, meaning as essentially appetitive. Such a limited view of meaning and experience seems unnecessarily zoomorphized, reductionistic, and impoverished. Libido theory has also tended to obscure the fact that both affects and thought are modes of knowing and are