Introduction to “Comparing Theories of Therapeutic Action”

From the early years of his work, Freud wrote with great assurance about the mechanism of the therapeutic action of psychoanalysis. As he learned more, and as his theories evolved accordingly, his confidence in his opinion about which aspects of psychoanalytic therapy account for its therapeutic effect apparently remained intact. This was so even though his understanding of what constitutes therapeutic efficacy developed and changed as his general theories about mental structure and psychoanalytic technique were modified and refined.

The subsequent appearance of alternative psychoanalytic theories has naturally brought shifts in their proponents' accounts of the pivotal aspects of therapeutic effectiveness. In the current climate of psychoanalytic theoretical pluralism, as we have come to call it, there exist quite substantial differences of opinion about this crucial aspect of our theoretical structure. In some quarters, at least, there is also acknowledgment that the certainty that characterized the early period of psychoanalysis's growth may have been unwarranted. Perhaps these changes in the culture of our field account for the upsurge in the last decade or so of papers and books that attempt to deal with the topic of therapeutic action.

This supplement of The Psychoanalytic Quarterly represents the coming to fruition of a several-year-long effort to address this increasingly complex situation. As the idea for this compendium was discussed and developed, it soon became clear that the scholarship required to present a balanced view of the literature of the many theoretical variations on this theme—not to mention that