Theory, Values and Clinical Concepts

The author of a contemporary work, Schools of Psychoanalytic Thought, 4 comments, “Freud's formulations had tremendous impact partly because they dealt openly with very real human problems in a vocabulary familiar to all of us. Unfortunately, the use of value-laden terms in the non-value context of a scientific theory readily leads to precisely the confusion and inappropriate antagonism that Freud encountered.” Dr. Munroe also writes with regard to Freudian concepts, “… they really have nothing to do with value judgments. They are ways of formulating observational material in a dynamic manner in whatever terms were most meaningful at the time.”

It may be true that originally there was no implication of evaluation in Freudian language. It does not seem reasonable or in keeping with what is known of psychology, however, to believe that a prefixed statement regarding the semantics of certain concepts will strip from the users of these concepts all other associations. A number of recent studies have indicated that not only are the meanings of many clinical concepts vague, but that there is also an evaluational component in the minds of the users of these concepts as they apply them in their clinical work. 1, 2 One can, if care is exerted, adopt a particular attitude relatively devoid of the commonsense meanings of terms. It is probably psychologically inevitable that apperceptive meaning creeps in no matter how carefully a word is defined, regardless of how specifically the point is made that when so-and-so uses such-and-such a word, it has one specific technical referent and no others. Many of these personal interpretations will be unique for a particular clinician, but in this paper the concern is not with the idiosyncratic private meanings contributed to concepts by their users. The focus of the discussion will be on the more or less culturally common, agreed upon, although relatively unwitting, value orientations