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The interface between the empirical base of psychoanalysis and its theoretical concepts has been an area for unending discussion, dispute, and debate. An extensive literature has developed dealing with questions regarding the manner in which psychoanalytic theory is generated on the basis of empirical clinical data, on the validity of such theoretical formulations, and particularly on issues related to problems of vertification (Sherwood, 1969; Eagle, 1973; Rubinstein, 1975; Thomae & Kaechele, 1975).
The same interface gives rise to a different set of problems when viewed in the perspective of the influence of theory on the clinical process. Puzzling questions arise that are difficult to resolve. Does theory make a difference in the clinical situation? If so, how? In what ways do theoretical formulations and understandings enter into and shape the clinical process? Does the whole of the theory make a difference or only some parts of it? What kind of theory might make such a difference? Does metapsychology make a real difference? And if so, how?
One particular current of recent psychoanalytic thinking has brought these issues into more dramatic focus. I refer to the radical criticism of psychoanalytic metapsychology and its related scientific methodology. The argument goes that psychoanalysis is in essence