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This interesting and engaging paper initially questions Greenberg's (2019) assumption that we need to adapt psychoanalytic technique for those rendered more vulnerable owing to developmental trauma. The author argues that we can (albeit with some variations): ‘recognize, understand and address these problems clinically and psychoanalytically from within a consistent and coherent theory of psychic development, therapeutic action, analytic process and technique’ (my italics). From this perspective, the seeming dichotomy between what we might call ‘drive/phantasy/wish-related pathology’ and ‘trauma-related pathology’ appears to be a false one. However, later in the paper, he seems to contradict himself when he states: ‘With patients who fall outside the category of neurosis, in order to facilitate the necessary therapeutic movements, analytic interventions must be flexible, intuitive and prepared to go beyond the confines of the assumptions of classical technique’.
The paper starts by helpfully exposing the confusion around the term trauma which, in English, is used to describe not only the cause and immediate impact but also the long-term consequences of an event. The author illustrates this: ‘It is as if an enormous rock fell into a lake producing a huge splash and ripples, which then caused long-term ecological damage and the same name was used to describe the rock hitting the water, the immediate disturbance that it produced and the eventual ecological changes that resulted’.
In psychoanalysis, Anna Freud (1967) cautioned that as a technical term, ‘trauma’ was in danger of being emptied of meaning through overuse and overextension. The paper considers whether trauma should be given special treatment aside from what Anna Freud calls ‘pathogenic influences in general’. However, the author remarks that this equanimity can go too far, e.g. his female colleague had a training analyst who never once questioned her or made an interpretation about her experience as a prisone