A Commentary on the Papers

I was asked to comment on these two psychotherapy articles written from the Klein-Bion perspective. Upon a careful reading of these interesting papers, it seemed to me that a number of very important issues were raised by the way each of these authors understood and applied their version of a mostly unaltered psychoanalytic theory to their clinical material in order to account for what happened in their treatment situation.

A few words about my views on once per week psychotherapy and its theoretical basis will lay the groundwork for what is to follow. As I see it, this branch of psychotherapy is really a form of applied analysis; that is, a very modified version of therapy which the parent theory was not initially designed to explain. Unless one bears in mind some of the major differences between the two therapies, one is likely to deceive oneself about the nature of the process.

In once a week therapy the process is generally quite different from that in psychoanalysis. Less attention has to be paid to working with the defensive organization, and derivatives of unconscious structures and fantasies are generally interpreted sooner with less material. One does not pay as much attention to the patient's reactions to interpretations, and the transference is often more difficult to isolate and to analyze. External reality intervenes more and the process is often carried out in a more intellectualized fashion than is the case in more traditional psychoanalysis. Finally, the therapist often comes to rely on other interventions more typical of supportive therapy. For example, his or her personal opinion will be offered, and the therapist generally comes across as a more “real figure” than is the case in more traditional analysis. All these features naturally affect the process and perforce the theoretical superstructure. Unfortunately, most writeups on once a week therapy fail to take the above