Chapter 11: The Authors Respond

I welcome the opportunity to comment about the discussions by Dr. Vacquer and Dr. Ornstein because they illustrate an important phenomenon that lies at the center of many current and past disagreements about psychoanalytic theory. I refer to the imbalance between theoretic views and the clinical evidence which is adduced to support those views. Before proceeding I wish to explain that space limitations prevent me from commenting on the valuable discussions by Brenner and Bronstein which agree, in essence, with my position. I have chosen instead to focus on the substantive issues of disagreement.

The philosopher Abraham Friedman once commented dryly that it is useful to make some distinctions about the discourse of psychoanalysts. He suggested that we should carefully distinguish between what the psychoanalyst says to his patient, what he says to himself, and what he says to his colleagues. The differences between the three forms of discourse are not a matter of discretion or integrity. They result from the well-known fact that the relation between proclaimed theory and actual practice is notoriously unpredictable. So, when analysts disagree, one of them often implies that the other is fooling himself about what he claims to understand about a patient. The analyst who disagrees usually believes, correctly or not, openly or tacitly, that the other has failed to see the difference between what he actually did or