The Theory of Therapeutic Action

The notion of a theory of therapeutic action suggests a defined method of therapy that has an effect (presumably positive, at least most of the time) upon patients, along with a hypothesis about the mechanism that leads to that effect. This hypothesis can then be tested, validated, invalidated, or in the ideal situation partially validated, leading to suggestions about how to alter the therapy so as to enhance its therapeutic action. As these eight papers by leading figures in the field make clear, psychoanalysis is not yet there!

First, psychoanalysis is not a “defined method” of therapy, but rather a number of different therapies (perhaps more different today than in the past) that share a history, many concepts and ideas, many surface similarities, and a community of discourse. However, they do not share a uniformity of method, agreement on what is essential and what is peripheral, or a theory of therapeutic action. These papers emphasize how each author's ideas differ from the others', rather than the qualities they share, as though they were vying for dominance in the struggle to define the essence of psychoanalysis, rather than searching for a set of unifying concepts that will accommodate all. These authors discuss their theories of pathology and of technique, and largely seem to assume that their theories of technique describe putative mechanisms of therapeutic action. For the most part, they do not seem particularly interested