Response to Sandberg and Busch

I did not intend to imply that the approach the authors take to the vast and probably heterogeneous collection of patients suffering from anxiety in varying degrees is without therapeutic value, only that it is important to analyze the particulars of what purports to be a unique therapeutic approach and its similarities and differences from existing theory and clinical practice.

The authors respond in three ways to my critique. The first is to offer information that is not contained in the article itself implying that the reader should already know and accept it. This includes stating that their method has been systematically studied and validated in comparison to other treatments; and that transference has been described as a central feature of PFPP. The second is to make assertions that seem at odds with statements and practices described in the article, such as denying both that the method is based on Fonagy's mentalization model, and that it has a strong educational component. The third is by misrepresenting me as claiming “that classical techniques are sufficient.”

No summary of studies systematically comparing PFPP to other treatments is presented in the article. In the vignettes chosen for illustration there is no evidence transference was considered, and indeed the term appears only once in the article and not in reference to the cases. Uncovering unconscious motivation in the context of transference is the quintessential element that distinguishes psychoanalytically informed therapies from educational ones that are based on suggestion and run the risk of false-self compliance. The patients presented do not seem severely disturbed and alexithymic like cases presented by others who have written about unrepresented emotion. And other than the absence of transference awareness I found no clear distinction between methods the authors used and commonly practiced psychodynamic therapies that attempt to uncover past roots of current problems and utilize interpretatio