Mark Bracher Responds

I thank Tim Dean and Cynthia Dyess for raising several important issues regarding psychoanalysis and historicism. First, there is “the crucial distinction between Lacanian clinical process and other kinds of psychoanalytic clinical practice.” I agree that it is important to distinguish among different kinds of clinical practice, but I do not believe that the most important distinction to be made is necessarily between Lacanian and non-Lacanian practice The crucial distinction, I believe, is that between psychoanalysis as I defined it in my analysis of historicism—that is, a practice that helps people uncover, identify, and own previously rejected parts of themselves—and other, supportive and/or expressive modes of therapy, the basic goal of which is some form of ego-consolidation. Both Lacanian and American analysts practice both kinds of treatment. My own analysis, for example, which was conducted by a training and supervising analyst certified by the American Psychoanalytic Association, involved virtually none of the kind of ego-consolidation that Lacan attributed to ego psychology. Rather than dividing the psychoanalytic world into Lacanian and non-Lacanian, it would be more productive to investigate similarities and differences within as well as between Lacanian and non-Lacanian schools concerning the fundamental aims, the basic strategies, the major techniques, the central processes, and the typical outcomes of psychoanalytic treatment.

It is also important to recognize the value of various supportive and expressive techniques, as, for example, when one is dealing with psychotic patients. Rather than universally disparaging supportive therapy, as some Lacanians do, it is more productive to recognize that for some severely disturbed patients, such work can produce a major improvement in well being, as some Lacanians who work with such patients have themselves recognized. Such a mode of therapy and social intervention should be criticized, however, when it functio