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Strenger's attempt to explore the foundations of our analytic knowledge will be of absorbing interest to all practitioners who are inclined to think about their work and come to terms with the ensuing uncertainties. As Sandler writes in his foreword, ‘the time has come to reflect on the nature of our work more profoundly’, an opinion which is today echoed by many analysts. For, although psychoanalysis has never lacked sceptics and opponents and has to some extent thrived on their presence, more and more penetrating questions are being asked by the analysts themselves. These cannot be ignored by simply continuing with the good work according to one's lights, a variety of theoretical formulations, and for as long as there is an adequate supply of patients.
Part I of this book is called ‘Recent Contributions in the Epistemology of Psycho-analysis’ and begins with Grünbaum's critique in The Foundations of Psychoanalysis . He is Strenger's prime example of a critic worthy of being taken seriously. His answer is detailed and spread throughout the book so that the reader does not need to have read the original in order to follow the debate. What, in essence, is it about?
In as much as analysis claims to be largely - but not exclusively - a method of therapy, the critics are quite within their rights to ask for evidence not only of its efficacy but also in the form of causal connections between the theories and the outcome; evidence, moreover, that is not only based on the narrative of one of the participants, nearly always the analyst. To point out that the work is based on a cohesive body of theoretical propositions supported by observations made in the consulting-room will not silence the critics, especially not in the absence of predictive criteria and statistical validation. It was therefore to be expected that Grünbaum should have concentrated his attack on what he calls Freud's ‘necessary condition’ thesis. It states that only true (psychoanalytic) insight has therapeu