Who Needs Theory of Therapeutic Action?

What is the therapeutic action of psychoanalysis? We knew the answer would be complicated, but the question seemed simple enough. The pages in this issue of The Psychoanalytic Quarterly show how wrong we were. The answers appear to be addressed to many different questions. Some contributors answer by defining their goals (for instance, happier living). Some answer by describing the general path to those goals (for instance, increased understanding). For some, a theory of action is evident in the contrast between psycho-pathology and the healed mind, theory of action being the side-by-side pictures of “before and after treatment” (e.g., the overlapping of fantasy and reality versus the ability to distinguish between them —first a weaker ego and then a stronger ego). Many contributors think the best way to answer the question is to endorse useful attitudes or to warn against unuseful ones (e.g., “Adopt an attitude of containment!” “Avoid imposing your own goals!” “Try not to dominate patients!”).

One contributor suggests that treatment action is whatever is common to the diverse schools. Some say the question is too difficult to answer, because treatment is too multifarious, complex and subtle, or too variable, or because the forces hide nonverbally in