Prologue

This issue of psychoanalytic inquiry takes off from a panel I chaired at the Annual Meeting of the American Psychoanalytic Association in Denver, in May, 1985. The title of the panel, The Relationship of Models of the Mind to Clinical Work, was fairly explicit in stating its purpose. In an attempt to explore the relation between theory and clinical work, detailed clinical material gathered by an analyst of one theoretical persuasion would be the focus of discussion by analysts of other theoretical persuasions. In this case the presenter is an adherent of structural theory.

The format for the panel was simple. A respected clinician, one clearly an adherent of structural theory, would present a short summary of a patient's history, the course of the analysis up to the present, and process notes on several consecutive sessions. This material would then be submitted to four discussants of different theoretical stances, who would offer their views of the patient's dynamics and their own therapeutic approach. We emphasized that we wanted a personal discussion rather than one representative of the theory espoused.

The task of enlisting a colleague to provide the clinical material was not as difficult as I had anticipated. I was, after all, asking someone to put his clinical practice on the line in a way that is rather unusual in psychoanalysis (except for candidates!), and I expected to meet with a certain amount of reluctance. Happily, the first person I called, Dr. Martin Silverman, agreed to participate. As he stated in a letter “… I would have taken notes on the first patient I saw after speaking with you, but he was a silent, intensely resistant patient who would not have offered useful material. So I simply took notes on the next patient's sessions. I think the material will do.” As the reader will see, it does very well indeed. It consists of a forthright, detailed, uncensored report of three successive sessions,