Comment on Interview with Dr. Peter Fonagy

One of the fine things about the psychoanalytic community is that we have forums for discussing ideas. Accordingly, I want to add a couple of different reactions to Dr. Fonagy's interview with Elliot Jurist. It is nice to note that his sentiments are well documented in his and Mary Target's 2003 volume on psychoanalytic theories (Fonagy & Target, 2003). Nonetheless, it seems to me that more can be said about a number of Dr. Fonagy's points in this interview.

First, about length of time for treatment, it must be true that narcissistic overdetermination of their behavior with patients cause some analysts to maintain analyses for their own satisfaction (and monetary gain). It is all too likely as expectable human behavior for this never to happen. To suggest that this was/is the usual is not backed up by any research that I know of. In fact, I have often mused that a tradition of analyst determination of an analysis' end caused too many cases of premature ending. The commonness of two or three analyses in series is one of the reasons that I wonder about this.

An excellent research on this question was done by Dr. Fonagy and Mary Target in 1994 (Fonagy & Target, 1994). They examined the value of psychoanalysis in treating disruptive children. They matched 135 children and adolescents whose diagnosis was disruptive disorder with 135 children and adolescents who suffered from obvious emotional disorders. After 1 year of psychoanalytic treatment, the latter group were greatly helped. The disruptive group were not. That finding has received considerable publicity. Of note, but getting less attention, the article goes on to state that of the disruptive children who remained in treatment for more than a year, 69% made significant gains. When the researchers compared only children of both groups who were in psychoanalysis for at least 3 years, there was no significant difference in improvement between children with nondisruptive symptoms and those who had been diagnosed as disru