I will forward this to Chris and hope he is willing to continue the dialogue.
Chris says, "I can't imagine what I could have written to make you think I
undervalue psychoanalytic theory. I think you have misunderstood, because I
certainlydo not have a 'negative attitude' to theory. I have studied hard in my
reading and discussion of the work of Freud, Klein, Bion and others, and my
supervision with Dr Segal certainly included consideration of relevant
theory. What I do feel is of limited use, especially on the internet is to
engage in disputes about theory in the absence of any clinical material." I
apologize for my misunderstanding of Chris's attitude toward theory, but I am
puzzled by his belief that theory should not be discussed in the absence of
clinical material, a belief probably shared by many listmembers. In the past I
have urged listmembers who are irritated by my posts to delete them, but now I
am asking for suggestions, public or private, on how I can make them interesting
enough so that more members would read them. Some time ago I posted a clinical
vignette, the adoptive mother, summarizing one of the cases in Wallerstein's 42
Lives. Some of the comments were quite interesting, but there seemed little
interest in my main point of using the case to illustrate the theoretical
concept of the impulse-defense equilibrium and how the double-prediction theory
helps to explain its relation to anxiety. It seems to me that for many basic
theoretical questions, there are so many relevant clinical examples that it is
pointless to lengthen the message by telling a clincial story. In fact, papers
in the psychoanalytic journals on basic theory often omit clinical cases. I
enjoy clinical material as much as anyone, but the details are not really
relevant to the reasons for believing one theory over another. It has been noted
in the psychoanalytic journals that most analysts dislike basic theory, and to
some extent I can sympathize with this feeling because many theoretical papers
seem to me verbose and confused (perhaps my posts seem this way as well, in
which case I wish someone would ask me to clarify whatever is unclear). I
anticipate limited success in arousing interest in basic theory in most
clinicians (I'm not being critical of this lack of interest because people
naturally vary widely in their interests). I have some hope of persuading
clinicians that basic theory is important even if it is boring. Clinicians want
to help their patients, so it is important to understand what causes
psychopathology and what the therapist can do to cause progress toward
therapeutic goals. Perhaps my inference that Chris does not value theory was
based on his insistence to discuss it only in connection with a clinical case.
If he is willing, I will try to show how his very interesting case leads to
basic theory. I had been thinking of doing this for some time and am sorry he
has decided to leave the list. Chris says, "In my work I give priority to trying
to attend to the patient in the moment
by moment movements in the session, and the theory is in the background.
Having one's psychoanalytic theory in the background is not to undervalue
it." This is only natural, but I wonder if Chris can say anything about what he
is looking for as he listens. I believe Greenson in his book on psychoanalytic
technique recommends listening for what the patient is avoiding. I am familiar
with all the talk about "even hovering attention," but I believe all therapists
listen to their patients in terms of some kind of theoretical preconceptions.
Eric Gillett, M.D.  [log in to unmask]