psychoanalytic community has been unnecessarily dismissing and critical. The response has been as to an encroachment, withdrawing further and further into increasingly specialist areas rather than seeking to join and develop together with the evolution of brain science. The irrational prevailing belief appears to be that hard-won psychoanalytic insights could somehow ‘be destroyed’ rather than elaborated and enriched by the new methods of inquiry. A further obstacle generated by the dichotomization of biology and patient care has been the anti- intellectual tendency of many psychoanalytic groups (Kandel, 1998). There is an assumed incompatibility between an astute and acute attention to the mental state of the patient. It is as if our observation of intellectualisation in our patients could somehow be automatically generalised to our own activities: from observing that a patient who reads and talks about science rather than feelings is not doing analysis, we appear to assume that an analyst who reads science also cannot be feeling and therefore cannot be practising analysis. There is an obvious element of truth in this attitude insofar that reading and keeping up with science is time consuming and must take away from time devoted to clinical work. However, to claim that the two activities are hostile to one another is clearly an expression of prejudice rather than fact and somewhat self-serving on the part of those who do not wish to engage in such activities. Fortunately, the generation of psychoanalytic clinicians whose original professional training has already encompassed the rapid advances we are discussing neither understands, nor can have much sympathy with, this approach. None of the major advances in psychiatric care are without their problems. SSRIs may turn out to have a significant placebo component (Verkes et al., 1998); ADHD is overdiagnosed, at least in the US (Goldman, Genel, Bezman, & Slanetz, 1998); there are common problems of compliance with neuroleptic medication (Kasper, 1998); there are well-publicised individual cases which document the failures of assertive community treatment; neuroimaging and genetic investigations have currently only a limited practical value. Arguments such as these should not be used to oppose developments in psychiatry but rather should be seen as opportunities for applying psychoanalytic insights in areas where there are significant shortcomings in the biological revolution. This requires taking a different approach: one of collaboration rather than confrontation. Before spelling out the specifics of such a collaborative approach, we should examine parallel developments in psychology. 1-%&)("B@,)"+&!#"$&:(A?-"B"LA& 1-%&"#)L)+@B&"M_%?,)"+(& The psychoanalytic attitude to psychology mirrors the attitude of psychoanalytic psychiatrists to experimental medicine and the rest of biology. Progress in psychology has been largely ignored by psychoanalysts, despite the fact that an increasing number of psychoanalytic practitioners received their basic training in clinical psychology. Again, historically there are a number of valid reasons for this: Psychology until the 1960s had an almost exclusive concern with behaviour and its models were largely based on studies of learning in animals (Skinner, 1953). Psychology traditionally had an antagonistic attitude to psychoanalysis, seeing it as a major, medically dominated rival in offering psychological care in mental health settings (Eysenck, 1952). Psychology retained a positivist influence upon its epistemology longer than most other social science disciplines. In fact its liberation from positivism is as much to be credited to progress in disciplines such as linguistics and sociology as to progress within its own domains (Chomsky, 1968). Principally as a consequence of the previous factors, clinical psychology was frequently purposely naïve in its approach to the evaluation and treatment of mental disorder (Ullmann & Krasner, 1969; Wolpe, 1969) – a naivety that was abhorrent to psychoanalysts who had fought hard to acquire a sophistication concerning the nature of mental processes and mental phenomena.
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