32nd Winter Meeting*: On “The Distinction Between Clinical Process and Clinical Content Theories”

Earl Witenburg chaired this special presentation that focused on a paper by Emanuel Peterfreund. Edgar Levinson, Rosemarie Sand, and Stanley Palombo followed with their reactions, criticisms, and opinions to what soon developed into a lively debate including many spirited responses from members of the audience.

Peterfreund stressed the need for a clear distinction between clinical process theory and clinical content theory. Process theory is defined as “the method of

investigation” while content theory refers to “the findings of the method of investigation.” Peterfreund feels as analysts we have extensively focused on content theory but very little work has been done on the way we collect data, the process. He presented criteria for assessing the usefulness of clinical hypotheses. First offer patients a tentative hypothesis or understanding. Good hypotheses may (1) cue memory, (2) change the direction of the hour, (3) relieve distress in the current hour and, (4) foster the therapeutic process. Analysts should not preformulate but “discover both the problems and the answers” with the patient. This paper is an extension of his 1983 book, The Process of Psychoanalytic Therapy, Models and Strategies.

Levinson argued that of course the process is important, but we must have a clinical theory to understand the findings. He stated that most analysts do not force theory on their analysands, but listen carefully to the material, and then utilize theory to help clarify and explain what is going on within the patient.

Sand stated that the psychoanalytic investigation is not relativistic, but historical. There must be truth in psychoanalysis, and it emerges in the dialogue between patient and analyst. She argued that through this process consensus could be found, that the examiner does not determine the truth, the clinical data does.

Palombo replied that Peterfreund's criteria for assessing the relative validity o