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More than a hundred years after its foundation, what psychoanalysis is, what a psychoanalytic treatment is, and how and on whom it works are very much in doubt, within the discipline and without. When spelled out in detail, few psychoanalytic propositions are treated consen-sually, even among psychoanalysts, as having a value as “real” in the sense that to ignore them is consequential. Nor are they agreed as useful truths, so that they necessarily limit the scope for competing beliefs and constitute a secure fund of knowledge from which any other proposition must take off.
As an example, the central concept of transference is a subject for dispute, being visited and re-visited with little clear consensus. Other key concepts for some — for instance, the therapeutic alliance, the castration complex, or the après coup — are almost irrelevant to others. Indeed, my impression (see also Hamilton, 1993; Schafer, 1983) is that few psychoanalysts would confidently feel able to set out a list of the core propositions of the discipline as a whole and at the same time expect, on close inspection and definition, close associates in their own country, let alone more distant colleagues, to agree.
Several questions seem pertinent. Why are there so many different groups and apparently isolated points of view in psychoanalysis? How do new ideas get adopted and why are they often so uncritically accepted or rejected? What can be said about the institutional arrangements in the field that hinder or facilitate the development of a secure and consensually agreed fund of knowledge?