Intrapsychic and Interpersonal Dimensions of Treatment: A Critical Dialogue. Robert Langs, M.D. and Harold Searles, M.D. New York:  Jason Aronson, 1980.

Robert Langs has attempted to redress what he considers a failure of the psychoanalytic community to concern itself with the “gradual development of a basic clinical psychoanalytic methodology.” Since his book Technique in Transition was published in 1978, Langs could not refer to the J.A.P.A. Supplement on “Psychoanalytic Technique and Theory of Therapy.” The issues of transference, the role of genetic interpretation versus the focus on the “here and now,” curative aspects of insight, and the working alliance were discussed.

However, I am inclined to think that this would in no way alter Langs's evaluation of what he regards as the current clinical “orthodoxy” in psychoanalysis. To read Langs, especially his recent two volume interviews with Stone and Searles, is to be impressed not so much with the “orthodoxy” of the International Psychoanalytic Community as with the “orthodoxy” of Langs. He has the zeal of a messiah and the rancor of a prophet in his critical assumptions that both analysts have deviated from the psychoanalytic “frame” and ignored transference reactions.

The “frame” is a basic structure emanating from the “primary adaptive context” of the analytic situation. The patient's communications in the analysis derive not simply from the derivatives of unconscious conflicts, infantile wishes, memories, and fantasies, but are stimulated by the specific interactional context in the analytic exchange. Borrowing from Freud's theory of the role of the day residue in the dream, Langs has extended this concept of the day residue to an even more primary role in the psychic structure. The day residue consists of those reality precipitates that either elicit an adaptive-reality response from the patient or set off a sequence of unconscious fantasies and memories related to the patient's “pathology, inner anxieties, and conflicts.” The most significant of the day residue content is aroused from the analyst's responses to the patient. Langs views these responses as piv