Response to Hanly, Reed, and Renik

This discussion will not be in the nature of a supervision of the clinical cases reported, but a commentary on the relationship of these clinical experiences to the two themes of this meeting. Both of these are intertwined, the question of one theory or many, and the fit between theory and practice. With regard to the latter, what do these therapeutic exchanges say about which theory, or theories, apply? Specifically, from what has been said thus far, how do they fare under the unitary, composite theory I have posited?

First, a tie does exist: theory affects practice, and clinic informs theory. The fear of imposing theory, from the rampant current edict against this pitfall, has led to a diminishing of the role of theory, to the point at times of a phobic reaction against it. I agree with Hanly that theories describe what is real, in our case psychic realities, and that they are to be used. But as Reed points out, theories are guides, not our masters. I do not agree with those who say that while theories may be different, treatments are the same (i.e., that theories do not matter). Theories, if we believe them, oblige us to apply them; and if the data “don't fit,” the theories should be changed.

The theory of neurosogenesis and the theory of therapy are also linked, and in that sense are unitary (another instance of unification). Our views of what causes neuroses should bear a relationship to our means of reversing them.

One unfortunate complication for the completeness of this presentation of the clinical and theoretical fit is that one of the contributors of clinical material, Owen Renik, felt unable to publish his case report for reasons intrinsic to the case. Accordingly, it becomes necessary to make do with the discussions of the case material, which were presented verbally, without the benefit of the actual case report. It is felt that the main points relevant to the topic of this panel can be