Meetings of the New York Psychoanalytic Society

September 30, 1985. ANALYSTS WHO WRITE, PATIENTS WHO READ. Martin H. Stein, M.D.

The writing of psychoanalytic papers, especially those which include clinical data, presents difficulties which are special, if not unique, to the profession. The need for discretion is only the most obvious of these. The use of brief clinical vignettes, rather than extensive case reports, allows writers to illustrate the derivation and application of their theoretical ideas without giving the kind of information that would reveal the identity of their patients. Even so, many very competent, even distinguished, analysts write little or nothing. This is no reflection on their clinical or theoretical capacities. There are many reasons why they may refrain: some lack writing skills; others are too diffident; many are too busy with other demands on their time. Some have never overcome their sensitivity to being subjected to criticism in public. Perhaps a large number value spoken exchanges, especially the art of interpretation, so highly that they feel hampered in subjecting their ideas to the limitations of a written text. A text allows for no immediate response or further qualification, and they fear that it is subject to misunderstandings for that reason. Another factor that may operate either to encourage or to inhibit is the writer's residual conflicts about his or her clinical experience. This may, as in the case of Dora, lead to the production of a classic; or it can result in self-justifying but otherwise valueless work. Much will depend upon how successful the writer has been in achieving self-understanding. The best writing takes the conflicts of the author into consideration, permitting the reader to follow the processes of the writer's thought as he or she delivers a clinical judgment or supports a hypothesis. Allowing the reader to become privy to the author's search for solutions, some to be discarded, others to be accepted as valid, carries, in the long run, a