Editors' Introduction

We here present three case histories, two extended, and one brief. In the first, medication as well as other parameters seemed clearly indicated, and the effects of such measures are traceable in the material. The first case, along with its preceding intake material, was presented at an Affiliated Staff Conference of the Treatment Center of the New York Psychoanalytic Institute and, as such, is representative of the type of psychoanalytic follow-up, or “CPC” case format which we will be employing frequently in the Journal. The second case presentation also includes the intake interviews which preceded the patient's acceptance for a Treatment Center analysis. In the second case, no medications were used, despite a prolonged course involving much acting out, agitation, mood swings, obsessional symptoms, and other disruptive phenomena which perhaps might lead some analysts today to consider the use of medication. Others would consider such phenomena as falling well inside the range of expectable psychopathology within a psychoanalytic process, and hence requiring neither drugs nor parameters of any sort. The two cases are not strictly comparable, since the first patient was clearly more disturbed than the second; yet the cases may serve as representative of the two approaches: treatment with drugs, and treatment without. The third, briefly summarized case is offered as a variant of the latter approach. Here the patient requested medication, but the analyst elected to analyze the request rather than grant it. All three cases will no doubt stir further controversy and the editors invite letters and comments from readers. We will take up in a future issue the problems raised by the traditional style and format of psychoanalytic case histories as presented here.