in terms of theory construction and elaboration. The value of theory based on clinical research is in supporting clinical work. Its weakness is its extensive reliance on induction and therefore its dramatic failure to aid the construction of a coherent, integrated and sound knowledge base which can systematically evolve and define the psychoanalytic approach. There are three conditions that should be met for clinical research to be an adequate sole methodology of psychoanalytic theory building. These are: (a) a close logical tie between theory and practice, (b) appropriate deductive reasoning in relation to clinical material and (c) the unambiguous use of terms. The first of these is an essential precondition for us to be able to assume that theory is not generated by technique. In order to be confident that there is no irreparable confound between technique and theory, we must be able to show that technique is entailed in theory; that is, that technique has a known and specifiable relationship with theory and thus the contamination of observations by technique, even if not possible to discount, can be specified. The second criterion, the one of deductive reasoning, must be satisfied if we are to show that observations serve both to prove and to disprove theoretical premises. The third criterion pertains to the possibility of the reliable labelling of observations. In the following sections I intend to show that none of these three criteria are met by current clinical research strategies. /%27($70!$6!*)(!0*(2$<0&!$*!(#0)%4! One of the major causes of the failure of the clinical research method is that, while we might wish this to be otherwise, in reality psychoanalytic clinical practice is not logically deducible from psychoanalytic clinical theory. While this is quite a radical premise, and one which even I only believe to be partially true, it is neither new (e.g. Berger, 1985; Fonagy, 1999), nor without considerable corroboration from the psychoanalytic literature. There are powerful arguments that support the general suggestion that psychoanalytic practice bears no logical relationship to theory. We shall only touch briefly on six of these: Psychoanalytic technique has arisen largely on the basis of trial and error, rather than as driven by theory. Freud (1912) willingly acknowledged this when he wrote: “the technical rules which I am putting forward have been arrived at from my own experience in the course of many years, after unfortunate results had led me to abandon other methods” (p.111). It is impossible to achieve any kind of one-to-one mapping between psychoanalytic therapeutic technique and any major theoretical framework. It is as easy to illustrate how the same theory can generate different techniques as how the same technique may be justified by different theories. For example, Gedo (1979) states that: “principles of psychoanalytic practice…[are]…based on rational deductions from our most current conception of psychic functioning” (p.16). His book makes the claim that the unfavourable outcomes of developmental problems can be reversed “only by dealing with those results of all antecedent developmental vicissitudes that later gave rise to maladaptation” (p.21). However, what sounds like a deduction, on closer examination turns out to be a hypothesis. It is one thing to presume and quite another to demonstrate that in therapy developmental vicissitudes require to be sequentially addressed. Many have powerfully challenged the overuse of the developmental metaphor (Mayes & Spence, 1994) and, even from within the self-psychology orientation to which Gedo belongs, the support for his strong assertion is limited (Kohut, 1984, pp. 42- 46). By contrast, it is equally striking how clinicians using very different theoretical frameworks can arrive at quite similar treatment approaches (Wallerstein, 1989/or 1992). The fact that we are not in agreement about how psychoanalysis works also suggests that practice is not logically entailed in theory. The nature of the therapeutic action of psychoanalysis is an inveterate theme for psychoanalytic conferences – started perhaps at the IPA conference at Marienbad (Panel, 1937). Since that time, at roughly 10 year intervals there has been a major symposium on the topic at either the meeting of the American or at the International Psychoanalytic Association and probably at least one in each of the intervening years in one of the major component organisations. If practice was
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