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One of the major virtues of Mr. Khan's article is the masterful presentation of his analytic experience and personal interaction with his three patients. Their condensed case histories are a lifelike portrayal of a special type of personality, seen through the eyes of a keen observer sensitive to the “dimmest fluctuations” of their behavior as well as to his own subtle “shifts of affect and mood.” I am also impressed by the lucid formulation of what he describes as their symbiotic omnipotence, and I wholly agree with his interpretation in terms of cumulative traumatic experiences in the early mother-child relationship.
The pragmatic value and ultimate therapeutic fruitfulness of his meta-psychological speculations is another matter. Indeed, I submit that the analyst's ever increasing refinements of theory and his excessive preoccupations with it are apt to detract from the authenticity of his clinical perceptiveness and from his impact as a therapeutic agent.
The reasons for doubts on this score cannot be fully substantiated in a brief note envisaged by the editors of this journal. But since they do encourage discussants to “challenge the author's methodology, his data or his conclusions1 and, presumably, to compare notes regarding the author's and the discussant's respective approaches to their patients, I feel justified in trying to vindicate, in the space available to me, what is likely to be a rather vulnerable minority opinion.
I submit that an as yet inadequately defined proportion of data elicited in the psychoanalytic situation is due to what I described as the patient's doctrinal compliance with his therapist's preconceived theoretical ideas and expectations regarding the validity of his “doctrine.” Doctrinal compliance, I stated, is in part the effect, in part the cause of the transference-countertransference configuration. This certainly does not mean that all the patient's productions merely reflect the therapist's countertransference but it calls for a tho