logically entailed in theory, we would undoubtedly have a clear theoretical explanation for therapeutic action. Theory and practice have been progressing at very different rates, with practice changing only in minor ways, relative to the major strides made by theories. It is quite realistic to contemplate a single volume account that would encompass most major technical advances (e.g. Clarkin, Kernberg, & Yeomans, 1999; Greenson, 1967; Kernberg, Selzer, Koenigsberg, Carr, & Appelbaum, 1989; Luborsky, 1984). Yet, no single person could hope to provide a scholarly and integrated account that would be faithful to all the enormous theoretical developments that have taken place over the past 100 years. The discrepancy in rates of progress between theory and practice is staggering and would be hard to understand were it not for the relative independence of these two activities. Psychoanalytic theory is largely not about clinical practice. Scarcely a single volume of Freud’s 23 volume corpus is devoted to papers on technique. So what is psychoanalytic theory about, if it is not about practice? It was intended as and remains an elaboration of a psychological model and the way that this may be applied to the understanding of mental disorder, and to a lesser extent, to other aspects of human behaviour – literature, the arts, history etc. The role of theory in practice underscores the inductive nature of clinical research. The value of theory to the psychoanalyst is in elaborating the meaning of behaviour in mental state terms. Thus there can be no question that theory is valuable – it is, however, intrinsically contaminated by practice. It is driven by what is practically helpful rather than the other way around, that is, practice being dictated by what is true about the mind. Thus the major criterion for assessing validity of clinical research findings is contaminated by a set of considerations unrelated to their accuracy. Certainly, in principle, a theory may be true but of little practical value (e.g., a mathematical theorem) or untrue but great practical relevance (e.g., religion, politics etc.). The loose relationship between technique and theory is a significant burden which clinical research carries. Theory serves to justify practice largely through analogy and metaphor and we must at all times be aware that what we are practising is based on cumulative clinical experience and what we are theorising may be a useful adjunct to clinical practice – but it cannot be its epistemic justification. "#0!1%)3<096!):!$*&B7($Y0!%026)*$*D!0c1<2$*!(#0!)Y0%23B*&2*70!):!(#0)%$62($)*! Clinical work and clinical observations provide the chief source of theory building in psychoanalysis. There is no question but that the psychoanalytic treatments provide a unique window on human behaviour and thus psychoanalytic theories are rich and imaginative in developmental, clinical and applied accounts. The limitation imposed on it is in part logical and in part psychological. The epistemic strategy of practising clinicians is, as we have seen, by necessity inductive. They are predisposed to find patterns in the therapeutic interaction which they can explain using existing theoretical constructs. In observing clinical material psychoanalysts opt for inductive reasoning in favour of pointing to instances where the antecedent is not followed by a consequent. The predominant psychodynamic epistemic strategy, encapsulated in the clinical case report, became one of enumerative inductivism (the sometimes exhaustive enumeration of instances consistent with the premise). From a clinical point of view this is an appropriate strategy. To enumerate examples of the influence of an unconscious pattern is not only a useful adjunct to interpretations (“every time you are feeling such and such you do so and so”) but also helps the psychoanalyst to feel on firmer ground in working creatively to elaborate a picture of the patient’s internal world. But, remembering Bertrand Russell’s quip once more, it is not persuasive to show that past pasts conform to past futures; that an association we have already observed is one more instance of a known family of associations. What the clinician’s mind finds much harder to tackle is the identification of
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