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Question Four: How does developmental theory influences practice? Panelists will hear a case presentation. We have asked them to address what developmental concepts they consider crucial to their work as clinicians, examples might include: projective identification, positions, transference, and unconscious fantasy. Since Freudians often think of pathology in terms of Oedipal and pre-Oedipal issues, it would be interesting to think about if, and how, Kleinians have something analogous to the structural view. Likewise, of interest is if there is a Freudian analogue to Kleinian notions of analyzability. We are hoping to illuminate any differences in technique, which hopefully will evolve through any discussion of the case.
My analytic technique has changed a great deal over the years, in large part because my belief in the mutative value of genetic interpretations has been destroyed by experience. For me genetic interpretations are, as Larry Hall once said, commemorative experiences—they may help stabilize growth in a patient, but only after therapeutic change has taken place. Thus, in spite of my ideas about human development—the sequential unfolding and interconnection of oral, anal, and infantile genital phases, the tremendous importance of the early mother-infant dyad, of Oedipal wishes and conflicts—these ideas do not form the basis of what I say to patients during an analysis, though I am certain they color my thinking about a patient's material as well as how and when I intervene. Instead, the issues that I think are important in working with a patient are.