Response to Dr. Baudry's Commentary

First of all I would like to thank Dr. Francis D. Baudry for his commentary and for giving me the opportunity to engage in a dialogue. Dr. Baudry begins by giving some interesting thoughts on the nature of once weekly psychotherapy and the importance of appreciating the difference between that and psychoanalysis. I would agree with his idea that the process and the intensity of the two modalities differ, inevitably influence the way we understand the patient, how we tailor the treatment, and how we apply or modify our technique. Dr. Baudry points out that the extent to which patients engage in once weekly treatment can vary depending on their ability for self-observation. I also think that the patient's readiness to embark and sustain herself or himself within a painful process, requires of the patient an epistemophilic instinct, a term coined to describe the curiosity to know and to understand (Pajaczkowska, 2000, p. 77). It is this that acts in the service of resilience on the part of the patient that will assist her or him to remain in touch with emerging, often overwhelming affects in the face of external reality. It is a quality that some patients are equipped with and which in my mind allows them to maximize the benefits of once weekly therapy. As a general point I believe that once weekly therapy in itself creates the foundation upon which analysis can proceed. In some cases, and drawing from my clinical experience, such a framework provides in itself a complete treatment, particularly where the patient displays the “epistemophilic instinct.” These considerations had been omitted from the article and no doubt would have shed light on the theoretical superstructure.

The first point about this article, is on the parameter introduced at the outset, to limit psychotherapy to a period of two years. For many of our patients on receipt of treatment within the public sector,