La pseudoscienza della psicoanalisi: una constatazione ...
Psicoanalisi e scienza: due piani su cui riflettere​​ Il primo: la dottrina psicoanalitica, cioè la teoria della mente fondata sulla dinamica ...
discussione
Sempre per rimanere nel concreto citerò due psicoanalisti. In primo luogo, il celeberrimo Peter Fonagy, molto tradotto in italiano e che guidò il Tavistock Study on Adult Depression, ritenuto da molti la prova che la psicoterapia psicodinamica è efficace. In una <anchor>discussione</anchor> svoltasi dieci anni fa sul British Journal of Psychiatry circa l'opportunità o meno che la rivista pubblicasse casi clinici di impianto psicoanalitico, si confrontò con il biologo Lewis Wolpert (già presidente della Royal Society) il quale sosteneva che andavano esclusi in quanto non scientifici. Fonagy ammetteva le critiche dell’avversario, ma difendeva la psicoanalisi affermando che la ricerca è possibile e che si cominciava a farla. Si cominciava! Fonagy si è impegnato a trovare metodi controllati per stabilire l’efficacia dei trattamenti psicoanalitici. Ma se si va a leggere il Tavistock Study, descrizione e risultati, si fa fatica a pensare che con quella metodologia si sia davvero dimostrato quel che si dichiara. Anche ammesso, i difensori dell’efficacia della psicoanalisi potrebbero fare una passeggiata nei boschi delle meta analisi pubblicate sul sito Cochrane: troverebbero poche meta analisi che riportano una relativa efficacia per le psicoterapie psicodinamiche (non per la psiconalisi) e si parla sempre di risultati che richiedono ulteriori studi, di campionamenti non casuali, di mancanza di controlli, di protocolli non trasparenti, etc.
There is no place for the psychoanalytic case report in the British Journal of Psychiatry | The British Journal of Psychiatry | Cambridge Core
There is no place for the psychoanalytic case report in the British Journal of Psychiatry \| The British Journal of Psychiatry \| Cambridge Core

Our systems are now restored following recent technical disruption, and we’re working hard to catch up on publishing. We apologise for the inconvenience caused. Find out more: https://www.cambridge.org/universitypress/about-us/news-and-blogs/cambridge-university-press-publishing-update-following-technical-disruption

[Skip to main content](#maincontent) [Accessibility help](/core/accessibility)

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to [manage your cookie settings](https://www.cambridge.org/about-us/legal-notices/cookies-policy/).

![Close cookie message](/core/cambridge-core/public/images/icn_circle__btn_close_white.svg)

## Login Alert

Cancel

[Log in](/core/login?ref=/core/journals/the-british-journal-of-psychiatry/article/there-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry/959F61577A05256FA6D5F72207EA5E61)

×

×

![](/core/cambridge-core/public/images/logo_core.png)

- ![Cambridge Core Home](/core/cambridge-core/public/images/logo_core.svg)Home

- [Log in](/core/login?ref=)
- [Register](/core/register?ref=/core/journals/the-british-journal-of-psychiatry/article/there-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry/959F61577A05256FA6D5F72207EA5E61)
- [Browse subjects](/core/browse-subjects)
- [Publications](/core/publications)
- [Open research](/core/open-research)
- [Services](/core/services)
- [About Cambridge Core](/core/about)
- [Cart](/core/shopping-cart)

- [Cart](/core/shopping-cart)

- [Institution login](https://shibboleth.cambridge.org/CJOShibb2/index?app=https%3A%2F%2Fwww.cambridge.org%2Fcore%2Fshibboleth%3Fref%3D%2Fcore%2Fjournals%2Fthe-british-journal-of-psychiatry%2Farticle%2Fthere-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry%2F959F61577A05256FA6D5F72207EA5E61)
- [Register](/core/register?ref=/core/journals/the-british-journal-of-psychiatry/article/there-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry/959F61577A05256FA6D5F72207EA5E61)
- [Log in](/core/login?ref=/core/journals/the-british-journal-of-psychiatry/article/there-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry/959F61577A05256FA6D5F72207EA5E61)
- [Cart](/core/shopping-cart)

[![Cambridge Core Home](/core/cambridge-core/public/images/logo_core.svg)Home](/core/)

- ![Cambridge Core Home](/core/cambridge-core/public/images/logo_core.svg)Home

- [Log in](/core/login?ref=)
- [Register](/core/register?ref=/core/journals/the-british-journal-of-psychiatry/article/there-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry/959F61577A05256FA6D5F72207EA5E61)
- [Browse subjects](/core/browse-subjects)
- [Publications](/core/publications)
- [Open research](/core/open-research)
- [Services](/core/services)
- [About Cambridge Core](/core/about)
- [Cart](/core/shopping-cart)

- [Cart](/core/shopping-cart)

- [Institution login](https://shibboleth.cambridge.org/CJOShibb2/index?app=https%3A%2F%2Fwww.cambridge.org%2Fcore%2Fshibboleth%3Fref%3D%2Fcore%2Fjournals%2Fthe-british-journal-of-psychiatry%2Farticle%2Fthere-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry%2F959F61577A05256FA6D5F72207EA5E61)
- [Register](/core/register?ref=/core/journals/the-british-journal-of-psychiatry/article/there-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry/959F61577A05256FA6D5F72207EA5E61)
- [Log in](/core/login?ref=/core/journals/the-british-journal-of-psychiatry/article/there-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry/959F61577A05256FA6D5F72207EA5E61)
- [Cart](/core/shopping-cart)

Hostname: page-component-7bb8b95d7b-5mhkq
Total loading time: 0
Render date: 2024-09-13T02:51:45.690Z
Has data issue: false
hasContentIssue false

- [Home](/core)
- > [Journals](/core/publications/journals)
- > [The British Journal of Psychiatry](/core/journals/the-british-journal-of-psychiatry)
- > [Volume 195 Issue 6](/core/journals/the-british-journal-of-psychiatry/issue/47D9034E591791D6249ACA55B8CC1E90)
- >There is no place for the psychoanalytic case report...

- English
- Français


![](https://static.cambridge.org/covers/BJP_0_0_0/the-british-journal-of-psychiatry.jpg)[The British Journal of Psychiatry](/core/journals/the-british-journal-of-psychiatry)

* * *

## Article contents

- [Summary](#sec0)
- [References](#references-list)

# There is no place for the psychoanalytic case report in the British Journal of Psychiatry

Published online by Cambridge University Press:
**02 January 2018**

[Lewis Wolpert](/core/search?filters%5BauthorTerms%5D=Lewis%20Wolpert&eventCode=SE-AU) and

[Peter Fonagy](/core/search?filters%5BauthorTerms%5D=Peter%20Fonagy&eventCode=SE-AU)

[![](data:image/svg+xml;base64,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)Show author details](#authors-details)

* * *

Lewis WolpertAffiliation:

Applied to Medicine, Department of Cell and Developmental Biology, University College London, Gower Street, London WC1E 6BT, UK. Email: l.wolpert@ucl.ac.uk

Peter FonagyAffiliation:

Educational and Health Psychology, University College London, Gower Street London WC1E 6BT, UK. Email: p.fonagy@ucl.ac.uk

* * *

- [Article](#article-tab)
- [eLetters (1)](#comments-tab)
- [Metrics](#metrics-tab)

[Article contents](#toc-list-mobile)

- [Summary](#sec0)
- [References](#references-list)

![](/core/page-component/img/save-pdf-icon.080470e.svg)Save PDF

[![](/core/page-component/img/pdf-download-icon.c7fb40c.svg)Save PDF (0.11 mb)](/core/services/aop-cambridge-core/content/view/959F61577A05256FA6D5F72207EA5E61/S0007125000251180a.pdf/there-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry.pdf) [![](/core/page-component/img/pdf-download-icon.c7fb40c.svg)View PDF\
\[Opens in a new window\]](/core/services/aop-cambridge-core/content/view/959F61577A05256FA6D5F72207EA5E61/S0007125000251180a.pdf/there-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry.pdf)![](/core/page-component/img/dropbox-icon.3d57046.svg)Save to Dropbox![](/core/page-component/img/google-drive-icon.a50193b.svg)Save to Google Drive![](data:image/svg+xml;base64,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)Save to Kindle

![](/core/page-component/img/close-icon.194b28a.svg)

![](/core/page-component/img/share-icon.cbcfad8.svg)Share

![](/core/page-component/img/close-icon.194b28a.svg)

![](/core/page-component/img/cite-icon.44eaaa4.svg)Cite [![](/core/page-component/img/rights-icon.d4a677c.svg)Rights & Permissions\
\[Opens in a new window\]](https://s100.copyright.com/AppDispatchServlet?publisherName=CUP&publication=BJP&title=There%20is%20no%20place%20for%20the%20psychoanalytic%20case%20report%20in%20the%20British%20Journal%20of%20Psychiatry&publicationDate=02%20January%202018&author=Lewis%20Wolpert%2C%20Peter%20Fonagy©right=Copyright%20%C2%A9%20Royal%20College%20of%20Psychiatrists%2C%202009%C2%A0&contentID=10.1192%2Fbjp.bp.109.064451&startPage=483&endPage=487&orderBeanReset=True&volumeNum=195&issueNum=6&oa=)

* * *

## Summary

As evidence-based mental health and the randomised controlled trial come to dominate the content of major psychiatric journals, the status and clinical utility of single case reports have been increasingly questioned. Arguably, owing to their subjective, anecdotal nature and unsuitability for rigorous scientific testing, this is particularly true of psychoanalytic case studies. Professor Peter Fonagy and Professor Lewis Wolpert debate here whether or not there is a place for such case reports in the British Journal of Psychiatry.

* * *

Type
In Debate

Information

[The British Journal of Psychiatry](/core/journals/the-british-journal-of-psychiatry)
,
[Volume 195](/core/journals/the-british-journal-of-psychiatry/volume/537483E36FB61CFDFC6B410FC3FCA43C)
,
[Issue 6](/core/journals/the-british-journal-of-psychiatry/issue/47D9034E591791D6249ACA55B8CC1E90), December 2009, pp. 483 - 487

DOI: [https://doi.org/10.1192/bjp.bp.109.064451\
\[Opens in a new window\]](https://doi.org/10.1192/bjp.bp.109.064451)

Copyright

Copyright © Royal College of Psychiatrists, 2009

## For

The main problem with psychoanalysis is that it makes no attempt to be based on science and so there are no general principles which a case history could use to help other patients. An analytic case history is essentially subjective and anecdotal, and it also ignores other approaches to mental illnesses. No analyst is likely to consider the possibility that the patients' condition may be due to a genetic defect or some other physical illness. For example, there is good evidence that depression has a strong genetic component and so does schizophrenia. It is unlikely that psychoanalysts would even recognise such diagnoses of the patient's condition. In addition, there is the problem that there are almost as many ideas about psychoanalysis as there are analysts. There is no one accepted theory. For example, Melanie Klein's hypotheses regarding internalisations during the first year of life leading to paranoid and depressive states is without evidence but is not generally accepted.

One analyst has recently examined views of analysts in the USA[Reference Cooper1](#ref1) and concluded that his study:

… reveals a plethora of newer ideas, some areas of consensus, and broad areas of disagreement concerning the meaning and value of the ideas that dominate our current discourse. While we welcome the “pluralism” that has partially replaced the “rejectionist” policy of only a few decades ago, our contemporary pluralism is, to a surprising degree, a multiplicity of authoritarian orthodoxies, each derived from a particular thinker, rather than a scientific discourse.

Modern psychoanalytic interventions are primarily intended to provide a special communication with the patient based on emotion, rather than to promote intellectual insight. Nevertheless, most psychoanalysts continue to stress the strong influence of unconscious elements affecting people's mental lives. There are no accepted diagnoses as in DSM–IV. In psychoanalytic thinking the patient is not suffering from a defined illness and so there is no attempt to find a cure. The technique is not laid down and each analyst will pursue their own approach to interpreting the patient's free associations. There is thus nothing useful to be learned from a case report on an individual that could help other patients. Each case is essentially the relationship between an analyst and a patient.

The relationship between the patient and an analyst is different from that with a psychiatrist, is very personal and not easily expressed or explained. It is claimed that the analyst takes in much of what oozes out of the patient in different non-verbal forms. The patient and analyst enter into a complex relationship. Freud wanted the case histories he wrote to have the stamp of science. On that score he believed he had failed, as an analysis involves what cannot be replicated, like free association. It only happens once. By contrast, the development of an embryo also only happens once, but scientific theory explains how it happens.

Evidence is not something which analysts have much respect for. Almost all ideas in psychoanalysis are not supported by reliable evidence. That we have in our minds an ego, superego and an id is without foundation. Then there are all the claims about dreams providing important information on the patient's thoughts, particularly their unconscious thoughts, for which evidence is again just not there. There is excessive emphasis on the influence of childhood, although many adults with symptom neuroses and character pathology have no history of childhood sexual or physical abuse. And where is the evidence for the Oedipus complex?

One of the problems with psychoanalysis is that it is difficult to be wrong as anything can be explained; there is no evidence with which it assesses any idea or claim. Every explanation seems possible, and this must make it very attractive to those who practise it – how nice to have virtually no constraints. Consider these typical views expressed by the analyst Adam Phillips:[Reference Phillips2](#ref2)

Psychoanalysis does not cure people but shows them what is incurable; the understanding of psychoanalysis involves a continual resistance to it; what happens in therapy has more to do with the therapist's past than the patients; brief therapy is no worse or better; what could be more mine and not mine than my own desire.

So how does one evaluate the technique and its ideas? Case histories would be of no value. In an analytic case study by Marco Chiesa[Reference Chiesa3](#ref3) we merely have a long history of the patient over several years. The analyst was very weary at times and the report does not even reach a conclusion.

By contrast, a good example of a case history published in this journal involved an unusual combination of three problems – depression, mild cognitive impairment and sleep disorder.[Reference Clarke, Williams and Kopelman4](#ref4) It was only after detailed questioning that the sleep laboratory confirmed rapid eye movement sleep behaviour disorder, which responded positively to a combination of drugs with nasal continuous positive airways pressure. Drugs do not enter into analytic-based treatments. Another example is the case of an intellectual disability due to a genetic defect on the X-chromosome.[Reference Robertshaw and MacPherson5](#ref5) Genes rarely enter into analytic thinking.

It is the insistence of analysts to live in a world of their own that makes it totally unsatisfactory for them to present a clinical case in this journal.

**Lewis Wolpert**

## Against

My debate with Professor Wolpert concerning psychoanalysis has a distinguished history.[Reference Fonagy and Wolpert6](#ref6) I will briefly respond to the issues raised, some of which I wholeheartedly agree with. Others are less well-informed and I am glad to have the opportunity to set the record straight.

First, Professor Wolpert describes psychoanalysis in a way that not everyone would recognise. For example, psychoanalysis does take genetics seriously, starting with Freud (e.g. Freud,[Reference Freud and Strachey7](#ref7) p. 239), but also some classical and more recent psychoanalysts who originated twin and adoption studies[Reference Haddad, Reiss, Spotts, Ganiban, Lichtenstein and Neiderhiser8](#ref8), [Reference Neubauer9](#ref9) or indeed my own inadequate musings.[Reference Fonagy10](#ref10) In fact, the point to be made, particularly in the light of recent evidence on gene–environment interaction, is not related to the futile debate about nurture _v_. nature but rather a far more interesting discourse concerning the role of human subjectivity in filtering environmental experience which might determine the emergence of phenotype from genotype. The key role for psychoanalysis is informing us about the psychological processes that could moderate the expression of particular genes, for example through influencing parental reactions to young children or through partner choice.[Reference Reiss, Cederblad, Pedersen, Lichtenstein, Ethammar and Neiderhiser11](#ref11), [Reference Reiss and Leve12](#ref12)

Is it true that psychoanalysts are not interested in diagnoses? It is undoubtedly accurate that psychoanalysts are deeply dissatisfied with current psychiatric nosology, which they see as being heavily promoted by the pharmacological industry and as being unhelpful clinically and poorly supported empirically.[Reference Luyten and Blatt13](#ref13)– [Reference Westen and Shedler15](#ref15) Professor Wolpert singled out depression as a particularly helpful categorisation, yet the National Institute for Health and Clinical Excellence guidelines identified major problems and considerable room for further research in the face of the heterogeneity of treatment responses to be found.[16](#ref16) Nor have analysts simply been carping about this; they have produced an 850-page volume[17](#ref17) representing the collaborative efforts of five major psychoanalytic organisations, as well as the Operationalised Psychodynamic Diagnostic system.[Reference Arbeitkreis18](#ref18) My intention here is not to promote these particular volumes but just to challenge Professor Wolpert's assertion that psychoanalysts are uninterested in issues of classification.

I also disagree with the claim that psychoanalysts have no respect for evidence. We may wish to enter an argument about what we mean by evidence, but I would make the strong claim that a group of psychoanalysts have for many decades been fully committed to testing psychoanalytic propositions, both in relation to models of the mind[Reference Luyten, Blatt and Corveleyn19](#ref19) and in relation to treatment efficacy.[Reference Gabbard, Gunderson and Fonagy20](#ref20) In fact, as it happens, two of the individuals chosen by Professor Wolpert as exemplars of the psychoanalytic community's disregard for evidence, Arnold Cooper and Marco Chiesa, would both consider themselves in this group. Chiesa has undertaken a productive programme of research explicitly demonstrating the limitations of therapeutic communities[Reference Chiesa and Fonagy21](#ref21)– [Reference Chiesa, Fonagy, Holmes and Drahorad23](#ref23) and Cooper has contributed to numerous empirical research programmes at Cornell Medical College, including the manualisation of a psychodynamic treatment of anxiety disorder.[Reference Milrod, Busch, Cooper and Shapiro24](#ref24)

I would like to formally invite Professor Wolpert to join the psychodynamic researchers' LISTSERV ( [psychodynamicresearch@yahoogroups.com](mailto:psychodynamicresearch@yahoogroups.com)), where more than 300 participants actively engaged in accumulating evidence pertinent to psychoanalysis, including biological, psychosocial and clinical research, share their reports, their findings and work in progress. No clinical discipline, to my knowledge, incorporates all its practitioners in research. Similarly in psychoanalysis, it is a relatively small cadre that carry out original research, but the clinical professionals' support for this work is far more tangible than may be the case in other disciplines such as general psychiatry. For example, the International Psychoanalytic Association has spent $3 million of its membership dues in recent years supporting a variety of psychoanalytic research projects. The German Psychoanalytic Association has funded a highly successful follow-up study and is currently supporting a prospective comparison study of psychoanalytic psychotherapy and cognitive–behavioural therapy (CBT).[Reference Leuzinger-Bohleber and Target25](#ref25) The members voluntarily contribute to these projects because, as we all know, it is extremely difficult to obtain statutory funding for psychoanalytic research. This may be largely a result of the pervasiveness of misconceptions about the unscientific nature of modern psychoanalysis.

Finally, on the issue of pluralism raised by Arnold Cooper's statement, I would agree that there is no single psychoanalytic perspective that has general acceptance within the field. I would maintain that this does not set psychoanalysis apart from other specialist fields of psychotherapy or even mature sciences such as physics or evolutionary biology. But as with these mature fields, to which psychoanalysis cannot yet hope to aspire, there are core constructs that are generally implicitly accepted and well evidenced by both clinical observation and empirical data. In fact, over the past three decades there has been a convergence of assumptions both across psychoanalytic groups and, even more impressively, across different psychotherapeutic specialisations, systemic, cognitive–behavioural, humanistic–experiential and psychoanalytic–psychodynamic. Most psychoanalysts now, as Freud had been towards the end of his career, are humbled by the enormous influence of genetic predisposition modulated by increasing understanding of developmental concepts such as resilience but are also excited by new data on the importance of childhood experience in brain development. Most psychoanalysts recognise that only through a thoroughgoing commitment to understanding ‘disease mechanisms’ will treatment approaches become optimal in alleviating the suffering associated with mental ill health. Psychoanalysis is the most comprehensive body of knowledge in relation to the complexity of human subjectivity. When its findings are made accessible through the stories of psychoanalysts' encounters with their patients, given judicious critical peer review, they can contribute significantly to this essential understanding.

**Peter Fonagy**

## For: rebuttal

Professor Fonagy does not deal with the key issue in our debate, namely whether the _Journal_ should publish psychoanalytic case histories as they are not evidence based. In my view, as I argued, they should not be published here because psychoanalysis is not a science. If I were analytically oriented maybe I would interpret his omission in terms of unconscious denial and fear of not having persuasive arguments, or perhaps of a heavy case falling on his toe when young?

Just consider what he has written.[Reference Gabbard, Gunderson and Fonagy20](#ref20)

Perhaps the most significant challenge facing those who would like to provide a manual of psychoanalytic technique is the loose relationship between psychoanalytic theory and clinical practice. It is impossible to achieve a one-to-one mapping between psychoanalytic therapeutic technique and any major theoretical framework. Theory and practice have progressed at very different rates – practice has changed in only minor ways relative to the major strides made by theories. Moreover, psychoanalytic theory is largely not about clinical practice. Even when psychoanalysts are working within the same theoretical framework, they find great difficulty in arriving at consensus as to the presence or absence of a psychoanalytic process.

This supports my objection that psychoanalysis is not a science, and so each case history would just be anecdotal, and every one would be different and no general principles would emerge. Each case history would just be a story about the relationship between the analyst and the patient. They would also ignore the biological basis of the problem which is so important in many cases.

Looking up the very few psychoanalytic case histories I could find, almost all were for children and they confirmed my views. The case described by Pretorius[Reference Pretorius26](#ref26) is little more than a story of the analyst's relationship with the boy. There does not seem to be any real theory. There is no evidence for his conclusion that the paper explores the different ways in which chronic trauma and the salient traumatic event, experienced in infancy, are repeated, recalled, and expressed verbally and through behaviour. In another case history, Yardino[Reference Yardino27](#ref27) comments, ‘I think the childhood memory and his associations indicate a very relevant moment of this analysis, difficult and fertile, in which the experiences of the analyst and the patient become entwined in the field of experiences.’ The analyst is much too involved for there to be a scientific approach.

Compare these with traditional psychiatric case histories. Robertshaw & MacPherson[Reference Robertshaw and MacPherson5](#ref5) show that a young man's intellectual disabilities are due to a genetic error in his X-chromosome. They argue that clinicians should have a high index of suspicion regarding a genetic disorder when meeting someone with a mild intellectual disability.

Another case involved a 74-year-old man with a 4-year history of low mood with increasing irritability and anhedonia associated with apathy, withdrawal from social activities and reduced daytime physical activity.[Reference Clarke, Williams and Kopelman4](#ref4) The onset of affective symptoms was precipitated by moving family home, and exacerbated by the subsequent divorce of his daughter. It was necessary to use a variety of techniques, which included brain computed tomography, magnetic resonance imaging, positron emission tomography, neuropsychological testing and nocturnal polysomnography, and detailed questioning. This led to recognising sleep behaviour disorder, which responded to drugs. Later, when sleep apnoea had been identified in addition, a combination of these drugs with nasal continuous positive airways pressure proved effective.

Turning to depression, the evidence that analysis is a good treatment is weak. Also, analysts would ignore the biological basis of some depressions such as the absence of light in winter, or that alpha-interferon causes depression, so patients treated with it for hepatitis must take antidepressants. There is also the problem with depression that analysis will probably present the patient with more negative events in their lives, which will make the depression worse.

Lewis Wolpert

## Against: rebuttal

In my last response I attempted to reply to Professor Wolpert's comments addressing the scientific status of psychoanalysis. So while I am open to his reconstruction of traumatic childhood toe injury, a more parsimonious account may be found in my evenly hovering attention to his discourse.

Professor Wolpert generously cites my comments on the relationship of theory and practice in psychoanalysis (even more torturously explored elsewhere; see Fonagy[Reference Fonagy28](#ref28)) and suggests that this loosely coupled relationship is a fatal objection to the use of psychoanalytic case histories. I would claim that psychoanalysis is not alone in finding the linking of theory and practice problematic at times, and in fact the series of articles exploring theory–practice relationships in the special issue of the _Journal of Child Clinical Psychology_ to which my own contribution belongs[Reference Fonagy29](#ref29) underscores this in relation to behaviour therapy, CBT and other popular modes of clinical practice.

So while I would not wish to give ground in relation to Professor Wolpert's objection to the scientific status of my chosen discipline, I will concede readily and enthusiastically that much current practice in reporting cases is deeply flawed, epistemologically as well as heuristically. I even agree with some of his objections, although not all. Professor Wolpert mentions two examples where, in his view, inferences made by the author are unsupported and potentially unsupportable by the clinical observation. I concede that there is a lack of rigour in the reporting of psychoanalytic case histories. Freud's conviction that what ultimately benefits the patient is the discovery of the truth led him to place perhaps undue emphasis on clinical data, permitting them to bear the dual epistemic burden of confirming (a) the analyst's understanding of the patient and (b) general psychoanalytic hypotheses concerning the nature of human development, psychological abnormality and the existence and characteristics of numerous psychic mechanisms. Grünbaum[Reference Grünbaum30](#ref30) examined this argument in detail and found it crucially flawed.

Simply stated, the problem is that by and large clinicians are epistemically dependent on their patients' responses to interpretations, even if their criteria for confirmation are more sophisticated than a simple reliance on symptomatic improvement (see Freud,[Reference Freud and Strachey31](#ref31) p. 263). Elsewhere I have suggested that the permissive nature of such strategies has resulted in an accumulation of successful case reports that appear to support an array of psychoanalytic propositions as well as diverse therapeutic methods (e.g. Fonagy & Target[Reference Fonagy and Target32](#ref32)). Case reports that were the hallmark of 19th-century clinical medicine, that used clinical observation and phenomenology as primary research tools, are simply incompatible with therapeutic approaches that arose out of 20th-century social science where the unequivocal establishment of causal connections between intervention and outcome came to be the primary criterion for evidence as embodied within randomised controlled trial (RCT) methodology or, at the level of the individual, experimental single-case studies.[Reference Fonagy, Moran, Miller, Luborsky and Barber33](#ref33)

There have been attempts at making clinical reports of the psychotherapeutic process more rigorous. Klumpner & Frank,[Reference Klumpner and Frank34](#ref34) for example, proposed a format for case reports that was somewhat more rigorous than the traditional psychoanalytic format and forced the author to make the logic of inference explicit. I do not believe that this has been taken up by the field to any great extent, and in my view it would be foolhardy to do so. Nothing short of a videotaped or at least tape-recorded analytic encounter could serve as appropriate basis for systematic study and even in that context I believe that the investigator should be someone other than the clinician in charge of the treatment. This kind of psychoanalytic case study has been productively used to help understand the psychotherapeutic process and we have learned important lessons. For example, it has been shown that effective interpretation to patients with borderline personality disorder depends on the prior establishment of a sound therapeutic alliance.[Reference Horwitz, Gabbard, Allen, Frieswyk, Colson and Newsom35](#ref35)

However, does this mean that there should be no space for even the traditional psychoanalytic case report in the pages of a scientific journal such as this one? I would argue that such reports should not be excluded. I would like Professor Wolpert to address an issue that in my view goes beyond the scientific credibility of psychoanalytic ideas, the latter issue being orthogonal to the status of case reports. The interpersonal process that exists between two human beings, the psychiatrist and the patient, is maintained in part by the scientific understandings and intuitions of the clinician, brought to bear on the individual case. But this is not the whole story. We know from large-scale studies such as the National Institute of Mental Health depression trial[Reference Elkin, Shea, Watkins, Imber, Sotsky and Collins36](#ref36) that even placebo can be effectively or ineffectively administered.[Reference Blatt, Sanislow, Zuroff and Pilkonis37](#ref37) In the NIMH trial, the clinician who was found to be most effective was better at bringing about relief from depression in her patients when administering placebo than the worst therapist was when administering imipramine. There is controversy concerning the variability attributable to the therapist in psychotherapy trials but the balance of expert opinion favours the view that a significant proportion of the variance belongs with the individual practitioner and the practitioner–patient pair, and is not readily reducible to demographic or personality features.[Reference Beutler, Malik, Alimohamed, Harwood, Talchi, Noble and Lambert38](#ref38)

Narrative descriptions of the clinical encounter can, I believe, convey aspects of the therapeutic interaction that are currently beyond the readily quantifiable but nevertheless represent an essential component of the art of psychotherapy. A surgeon's technique will determine the rate of complications and the contribution of the clinician is now recognised by the revised CONSORT guidelines[Reference Moher, Schulz and Altman39](#ref39)as an essential source of variance that must be declared in RCTs. Beyond familiarity with the broad outlines of a treatment package as described and assessed in reports of RCTs, the how of psychological therapy also needs to be taught and this may be most effectively conveyed by treatment process reports even if these are idealised representations of the therapeutic encounter.

**Peter Fonagy**

## For: Conclusions

We have so far not mentioned cognitive therapy, which differs significantly from psychoanalysis. It deals with the patient's conscious thoughts and beliefs, particularly their negative ones, and tries to alter these where appropriate. An aim of the therapy is to alter the patients' behaviour and they are asked to keep a diary. This can be very helpful as the patient may believe that there will never be any improvement but they can see from their diary that there are some good days. A number of case studies using CBT have been published. A nice example is the treatment of patients with Parkinson's disease and depression.[Reference Dobkin, Allen and Menza40](#ref40)

The treatment involved training in stress management, behavioural modification, sleep hygiene, relaxation techniques, and cognitive restructuring. Treatment began by identifying life stressors that appeared to be contributing to depressed mood… We established a focus on meaningful activities early in treatment in order to help patients maintain and/or achieve a sense of purpose and fulfilment in their lives, despite the progressive nature of Parkinson's disease. Patients were also encouraged to adjust their expectations of themselves, expanding the repertoire of activities that they found to be enjoyable and “do-able”, in order to maximise the amount of positive reinforcement derived from the environment. Pleasant activities were also hypothesised to decrease the patients' focus on their physical condition. Because all patients had sleep difficulties, we introduced sleep hygiene techniques, such as avoiding daytime naps and establishing bedtime and wake-up routines. Overall, behavioural strategies were intended to help patients maximise control in their lives.

One can see how a case report on CBT makes sense. More detailed information is contained in Blackburn & Davidson,[Reference Blackburn and Davidson41](#ref41) which provides examples of the dialogue between therapist and patient. But it is not just the dialogue that matters but what the patient does to alter their thinking and behaviour.

I recognise how careful one has to be in determining the effectiveness of any therapy for mental illness as the placebo can play a key role, but with psychoanalysis I remain unconvinced that case reports will be of any help, and so the _Journal_ should not publish them.

**Lewis Wolpert**

## Against: Conclusions

I accept that current psychoanalytic case studies are often not consistent with the minimal standards of reliable reporting that the _Journal_ has the right to expect. Special pleading for a unique epistemology for psychoanalysis[Reference Leuzinger-Bohleber and Target25](#ref25), [Reference Hampe and Hampe42](#ref42) is no more justified than it would be for any other subdiscipline of the mental health sciences.

However, I would wish to assert that there is nothing inherently unscientific about the psychoanalytic clinical situation. Its intensity and particular interpersonal resonances continue to offer unique insights vital for the understanding of the human social condition. It enables us to question that which we normally overlook. As Jonathan Lear put it: ‘psychoanalysis begins in wonder that the unintelligibility of the events which surround one do not cause more wonder’ (see Lear,[Reference Lear43](#ref43) p. 28). We remain blind to the proliferation of meanings for which human subjectivity is responsible but which escapes it – ‘knowingness’, as Lear terms it. This is a cultural condition as well as an individual state of mind. The commitment of psychoanalysis to this pursuit becomes vital to the human enterprise when confronting massive social problems that hide behind the ordinary, Hannah Arendt's ‘banality of evil’ that is not executed by fanatics or sociopaths but rather by ordinary people who accept the premises of their social context and therefore participate with the view that their actions are normal. Moreover, how else can one come to understand the motivation of child abusers, war criminals, terrorists and murderers? These are aspects of human behaviour that have to be studied in depth and in a ‘no holds barred’ exploration of personal meanings. Equally, on a more positive note, the psychoanalytic clinical situation can illuminate how people survive adversity. More generally, wherever a question is socially important and where we need reflection to check out how well our reasoning is going, case reports of intensive psychotherapy can provide important understandings about the thoughts, wishes, and beliefs and desires characterising such unusual individuals, and can provide a fertile source of hypotheses about psychological causes of destructive or constructive action.

Obviously, case studies will be more interesting if placed in the context of other independent measures. Developmental psychopathology has made us aware that brain development affects behaviour but experience also affects brain development.[Reference Cicchetti, Valentino, Cicchetti and Cohen44](#ref44) For example, we know that in some of those who have suffered emotional abuse, cerebral spinal fluid oxytocin levels appear to be low.[Reference Heim, Young, Newport, Mletzko, Miller and Nemeroff45](#ref45) Would it not be fascinating to know how the proliferation of meanings in the minds of these individuals differs from those whose oxytocin was not affected in this way? Such examples provide a clue about the minimal criteria for admitting a psychoanalytic case study into the _Journal_. These criteria should include:

1. (a) the case study should be hypothesis-driven (i.e. start with a research question before the patient was seen);

2. (b) the reporting and recording methods of the process should meet with minimal standards of replicability;

3. (c) the reporting should be transparent and open to public scrutiny, including perhaps the provision of full case reports as supplementary materials;

4. (d) assurance should be available that the patient has offered informed consent both to the recording and to the report;

5. (e) an acceptable supplementary methodology of either a quantitative or a qualitative type should be used to ensure the triangulation of findings.


Psychoanalysis has survived as a psychology in the evolutionary battle of ideas because it has made unique contributions, sharpening our vision of man throughout the 20th century. This learning was based on clinical enquiry with all the limitations that Professor Wolpert has pointed to. I wish to strongly advocate that the meticulous study of human subjectivity offered by the inter-subjective experience of psychotherapy be combined with novel methods of neuroscience and molecular genetics as well as the established methods of systematic social science research in order to take us to a new era of discovery based in clinical work.

**Peter Fonagy**

* * *

## References

1

1Cooper, AM. American psychoanalysis today: a plurality of orthodoxies. Am Acad Psychoanal Dyn Psychiatry2008; 36: 235–53. [Google Scholar](https://scholar.google.com/scholar_lookup?title=American+psychoanalysis+today%3A+a+plurality+of+orthodoxies&author=Cooper+AM&publication+year=2008&journal=Am+Acad+Psychoanal+Dyn+Psychiatry&volume=36)

2

2Phillips, A. Side Effects. Penguin, 2007. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Side+Effects&author=Phillips+A&publication+year=2007)

3

3Chiesa, M. Pathological organisations of the personality: a clinical case study. Br J Psychother2007; 23: 395–410. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Pathological+organisations+of+the+personality%3A+a+clinical+case+study&author=Chiesa+M&publication+year=2007&journal=Br+J+Psychother&volume=23&pages=395-410)

4

4Clarke, NA, Williams, AJ, Kopelman, MD. Rapid eye movement sleep behaviour disorder, depression and cognitive impairment. Case study. Br J Psychiatry2000; 176: 189–92. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Rapid+eye+movement+sleep+behaviour+disorder%2C+depression+and+cognitive+impairment.+Case+study&author=Clarke+NA&author=Williams+AJ&author=Kopelman+MD&publication+year=2000&journal=Br+J+Psychiatry&volume=176)

5

5Robertshaw, BA, MacPherson, J. Scope for more genetic testing in learning disability. Case report of an inherited duplication on the X-chromosome. Br J Psychiatry2006; 189: 99–101. [CrossRef](https://dx.doi.org/10.1192/bjp.189.2.99) [Google Scholar](https://scholar.google.com/scholar_lookup?title=Scope+for+more+genetic+testing+in+learning+disability.+Case+report+of+an+inherited+duplication+on+the+X-chromosome&author=Robertshaw+BA&author=MacPherson+J&publication+year=2006&journal=Br+J+Psychiatry&volume=189&doi=10.1192%2Fbjp.189.2.99&pages=99-101) [PubMed](https://www.ncbi.nlm.nih.gov/pubmed/16880477)

6

6Fonagy, P, Wolpert, L. Has Freudian psychoanalysis been killed by pills? \[Debate\]. Prospect1999; November: 16–20. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Has+Freudian+psychoanalysis+been+killed+by+pills%3F+%5BDebate%5D&author=Fonagy+P&author=Wolpert+L&publication+year=1999)

7

7Freud, S. Three essays on the theory of sexuality. In The Standard Edition of the Complete Psychological Works of Sigmund Freud (volume 7) (ed Strachey, J): 123–230. Hogarth Press, 1937. [Google Scholar](https://scholar.google.com/scholar_lookup?title=The+Standard+Edition+of+the+Complete+Psychological+Works+of+Sigmund+Freud&author=Freud+S&author=Strachey+J&publication+year=1937&pages=123-230)

8

8Haddad, SK, Reiss, D, Spotts, EL, Ganiban, J, Lichtenstein, P, Neiderhiser, JM. Depression and internally directed aggression: genetic and environmental contributions. J Am Psychoanal Assoc2008; 56: 515–50. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Depression+and+internally+directed+aggression%3A+genetic+and+environmental+contributions&author=Haddad+SK&author=Reiss+D&author=Spotts+EL&author=Ganiban+J&author=Lichtenstein+P&author=Neiderhiser+JM&publication+year=2008&journal=J+Am+Psychoanal+Assoc&volume=56)

9

9Neubauer, PB. Nature's Thumbprint: The New Genetics of Personality (2nd edn). Columbia University Press, 1996. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Nature's+Thumbprint%3A+The+New+Genetics+of+Personality&author=Neubauer+PB&publication+year=1996)

10

10Fonagy, P. The development of psychopathology from infancy to adulthood: the mysterious unfolding of disturbance in time. Infant Ment Health J2003; 24: 212–39. [CrossRef](https://dx.doi.org/10.1002/imhj.10053) [Google Scholar](https://scholar.google.com/scholar_lookup?title=The+development+of+psychopathology+from+infancy+to+adulthood%3A+the+mysterious+unfolding+of+disturbance+in+time&author=Fonagy+P&publication+year=2003&journal=Infant+Ment+Health+J&volume=24&doi=10.1002%2Fimhj.10053)

11

11Reiss, D, Cederblad, M, Pedersen, NL, Lichtenstein, P, Ethammar, O, Neiderhiser, JM, et al. Genetic probes of three theories of maternal adjustment: II. Genetic and environmental influences. Fam Process2007; 40: 261–72. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Genetic+probes+of+three+theories+of+maternal+adjustment%3A+II.+Genetic+and+environmental+influences&author=Reiss+D&author=Cederblad+M&author=Pedersen+NL&author=Lichtenstein+P&author=Ethammar+O&author=Neiderhiser+JM&publication+year=2007&journal=Fam+Process&volume=40)

12

12Reiss, D, Leve, L. Genetic expression outside the skin: clues to mechanisms of Genotype Environment interaction. Dev Psychopathol2007; 19: 1005–27. [CrossRef](https://dx.doi.org/10.1017/S0954579407000508) [Google Scholar](https://scholar.google.com/scholar_lookup?title=Genetic+expression+outside+the+skin%3A+clues+to+mechanisms+of+Genotype+Environment+interaction&author=Reiss+D&author=Leve+L&publication+year=2007&journal=Dev+Psychopathol&volume=19&doi=10.1017%2FS0954579407000508)

13

13Luyten, P, Blatt, SJ. Looking back towards the future: is it time to change the DSM approach to psychiatric disorders? The case of depression. Psychiatry2007; 70: 85–99. [CrossRef](https://dx.doi.org/10.1521/psyc.2007.70.2.85) [Google Scholar](https://scholar.google.com/scholar_lookup?title=Looking+back+towards+the+future%3A+is+it+time+to+change+the+DSM+approach+to+psychiatric+disorders%3F+The+case+of+depression&author=Luyten+P&author=Blatt+SJ&publication+year=2007&journal=Psychiatry&volume=70&doi=10.1521%2Fpsyc.2007.70.2.85&pages=85-99) [PubMed](https://www.ncbi.nlm.nih.gov/pubmed/17661536)

14

14Russ, E, Shedler, J, Bradley, R, Westen, D. Refining the construct of narcissistic personality disorder: diagnostic criteria and subtypes. Am J Psychiatry2008; 165: 1473–81. [CrossRef](https://dx.doi.org/10.1176/appi.ajp.2008.07030376) [Google Scholar](https://scholar.google.com/scholar_lookup?title=Refining+the+construct+of+narcissistic+personality+disorder%3A+diagnostic+criteria+and+subtypes&author=Russ+E&author=Shedler+J&author=Bradley+R&author=Westen+D&publication+year=2008&journal=Am+J+Psychiatry&volume=165&doi=10.1176%2Fappi.ajp.2008.07030376) [PubMed](https://www.ncbi.nlm.nih.gov/pubmed/18708489)

15

15Westen, D, Shedler, J. Personality diagnosis with the Shedler-Westen Assessment Procedure (SWAP): integrating clinical and statistical measurement and prediction. J Abnorm Psychol2007; 116: 810–22. [CrossRef](https://dx.doi.org/10.1037/0021-843X.116.4.810) [Google Scholar](https://scholar.google.com/scholar_lookup?title=Personality+diagnosis+with+the+Shedler-Westen+Assessment+Procedure+(SWAP)%3A+integrating+clinical+and+statistical+measurement+and+prediction&author=Westen+D&author=Shedler+J&publication+year=2007&journal=J+Abnorm+Psychol&volume=116&doi=10.1037%2F0021-843X.116.4.810) [PubMed](https://www.ncbi.nlm.nih.gov/pubmed/18020727)

16

16National Institute for Health and Clinical Excellence. Depression: Management of Depression in Primary and Secondary Care. NICE, 2004. [Google Scholar](https://scholar.google.com/scholar?q=16+National+Institute+for+Health+and+Clinical+Excellence.+Depression:+Management+of+Depression+in+Primary+and+Secondary+Care.+NICE,+2004.)

17

17Alliance of Psychoanalytic Organizations. Psychodynamic Diagnostic Manual (PDM). Interdisciplinary Council on Developmental & Learning Disorders, 2006. [Google Scholar](https://scholar.google.com/scholar?q=17+Alliance+of+Psychoanalytic+Organizations.+Psychodynamic+Diagnostic+Manual+(PDM).+Interdisciplinary+Council+on+Developmental+&+Learning+Disorders,+2006.)

18

18Arbeitkreis, OPD (ed). Operationalisierte Psychodynamische Diagnostik: Grundlagen und Manual. Hans Huber, 1996. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Operationalisierte+Psychodynamische+Diagnostik%3A+Grundlagen+und+Manual&author=Arbeitkreis+OPD&publication+year=1996)

19

19Luyten, P, Blatt, SJ, Corveleyn, J. Minding the gap between positivism and hermeneutics in psychoanalytic research. J Am Psychoanal Assoc2006; 54: 571–610. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Minding+the+gap+between+positivism+and+hermeneutics+in+psychoanalytic+research&author=Luyten+P&author=Blatt+SJ&author=Corveleyn+J&publication+year=2006&journal=J+Am+Psychoanal+Assoc&volume=54&pages=571-610)

20

20Gabbard, GO, Gunderson, JG, Fonagy, P. The place of psychoanalytic treatments within psychiatry. Arch Gen Psychiatry2002; 59: 505–10. [CrossRef](https://dx.doi.org/10.1001/archpsyc.59.6.505) [Google Scholar](https://scholar.google.com/scholar_lookup?title=The+place+of+psychoanalytic+treatments+within+psychiatry&author=Gabbard+GO&author=Gunderson+JG&author=Fonagy+P&publication+year=2002&journal=Arch+Gen+Psychiatry&volume=59&doi=10.1001%2Farchpsyc.59.6.505) [PubMed](https://www.ncbi.nlm.nih.gov/pubmed/12044192)

21

21Chiesa, M, Fonagy, P. Psychosocial treatment for severe personality disorder. 36-month follow-up. Br J Psychiatry2003; 183: 356–62. [CrossRef](https://dx.doi.org/10.1192/bjp.183.4.356) [Google Scholar](https://scholar.google.com/scholar_lookup?title=Psychosocial+treatment+for+severe+personality+disorder.+36-month+follow-up&author=Chiesa+M&author=Fonagy+P&publication+year=2003&journal=Br+J+Psychiatry&volume=183&doi=10.1192%2Fbjp.183.4.356) [PubMed](https://www.ncbi.nlm.nih.gov/pubmed/14519615)

22

22Chiesa, M, Fonagy, P, Holmes, J. Six-year follow-up of three treatment programs to personality disorder. J Personal Disord2006; 20: 493–509. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Six-year+follow-up+of+three+treatment+programs+to+personality+disorder&author=Chiesa+M&author=Fonagy+P&author=Holmes+J&publication+year=2006&journal=J+Personal+Disord&volume=20&pages=493-509)

23

23Chiesa, M, Fonagy, P, Holmes, J, Drahorad, C. Residential versus community treatment of personality disorders: a comparative study of three treatment programs. Am J Psychiatry2003; 161: 1463–70. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Residential+versus+community+treatment+of+personality+disorders%3A+a+comparative+study+of+three+treatment+programs&author=Chiesa+M&author=Fonagy+P&author=Holmes+J&author=Drahorad+C&publication+year=2003&journal=Am+J+Psychiatry&volume=161)

24

24Milrod, B, Busch, F, Cooper, A, Shapiro, T. Manual of Panic-Focused Psychodynamic Psychotherapy. American Psychiatric Publishing, 1997. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Manual+of+Panic-Focused+Psychodynamic+Psychotherapy&author=Milrod+B&author=Busch+F&author=Cooper+A&author=Shapiro+T&publication+year=1997)

25

25Leuzinger-Bohleber, M, Target, M, (eds). The Outcomes of Psychoanalytic Treatment. Whurr, 2002. [Google Scholar](https://scholar.google.com/scholar_lookup?title=The+Outcomes+of+Psychoanalytic+Treatment&author=Leuzinger-Bohleber+M&author=Target+M&publication+year=2002)

26

26Pretorius, IM. Repeating and recalling preverbal memories through play: the psychoanalysis of a six-year-old boy who suffered trauma as an infant. Psychoanal Study Child2007; 62: 239–62. [CrossRef](https://dx.doi.org/10.1080/00797308.2007.11800791) [Google Scholar](https://scholar.google.com/scholar_lookup?title=Repeating+and+recalling+preverbal+memories+through+play%3A+the+psychoanalysis+of+a+six-year-old+boy+who+suffered+trauma+as+an+infant&author=Pretorius+IM&publication+year=2007&journal=Psychoanal+Study+Child&volume=62&doi=10.1080%2F00797308.2007.11800791) [PubMed](https://www.ncbi.nlm.nih.gov/pubmed/18524094)

27

27Yardino, SM. ‘Break point’: a significant moment in the transference. Int J Psychoanal2008; 89: 241–7. [Google Scholar](https://scholar.google.com/scholar_lookup?title=%E2%80%98Break+point%E2%80%99%3A+a+significant+moment+in+the+transference&author=Yardino+SM&publication+year=2008&journal=Int+J+Psychoanal&volume=89)

28

28Fonagy, P. Some complexities in the relationship of psychoanalytic theory to technique. Psychoanal Q2003; 72: 13–47. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Some+complexities+in+the+relationship+of+psychoanalytic+theory+to+technique&author=Fonagy+P&publication+year=2003&journal=Psychoanal+Q&volume=72&pages=13-47)

29

29Fonagy, P. The relation of theory and practice in psychodynamic therapy. J Clin Child Psychol1999; 28: 513–20. [Google Scholar](https://scholar.google.com/scholar_lookup?title=The+relation+of+theory+and+practice+in+psychodynamic+therapy&author=Fonagy+P&publication+year=1999&journal=J+Clin+Child+Psychol&volume=28)

30

30Grünbaum, A. The Foundations of Psychoanalysis: A Philosophical Critique. University of California Press, 1984. [Google Scholar](https://scholar.google.com/scholar_lookup?title=The+Foundations+of+Psychoanalysis%3A+A+Philosophical+Critique&author=Gr%C3%BCnbaum+A&publication+year=1984)

31

31Freud, S. Analysis terminable and interminable. In The Standard Edition of the Complete Psychological Works of Sigmund Freud (volume 23) (ed Strachey, J): 209–53. Hogarth Press, 1937. [Google Scholar](https://scholar.google.com/scholar_lookup?title=The+Standard+Edition+of+the+Complete+Psychological+Works+of+Sigmund+Freud&author=Freud+S&author=Strachey+J&publication+year=1937)

32

32Fonagy, P, Target, M. Psychoanalytic Theories: Perspectives from Developmental Psychopathology. Whurr, 2003. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Psychoanalytic+Theories%3A+Perspectives+from+Developmental+Psychopathology&author=Fonagy+P&author=Target+M&publication+year=2003)

33

33Fonagy, P, Moran, G.S. Selecting single case research designs for clinicians. In Psychodynamic Treatment Research: A Handbook for Clinical Practice (eds Miller, NE, Luborsky, L, Barber, JP et al): 62–95. Basic Books, 1993. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Psychodynamic+Treatment+Research%3A+A+Handbook+for+Clinical+Practice&author=Fonagy+P&author=Moran+G.S&author=Miller+NE&author=Luborsky+L&author=Barber+JP&publication+year=1993&pages=62-95)

34

34Klumpner, GH, Frank, A. On methods of reporting clinical material. J Am Psychoanal Assoc1991; 39: 537–52. [Google Scholar](https://scholar.google.com/scholar_lookup?title=On+methods+of+reporting+clinical+material&author=Klumpner+GH&author=Frank+A&publication+year=1991&journal=J+Am+Psychoanal+Assoc&volume=39)

35

35Horwitz, L, Gabbard, GO, Allen, JG, Frieswyk, SH, Colson, DB, Newsom, GE, et al. Borderline Personality Disorder: Tailoring the Psychotherapy to the Patient. American Psychiatric Press, 1996. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Borderline+Personality+Disorder%3A+Tailoring+the+Psychotherapy+to+the+Patient&author=Horwitz+L&author=Gabbard+GO&author=Allen+JG&author=Frieswyk+SH&author=Colson+DB&author=Newsom+GE&publication+year=1996)

36

36Elkin, I, Shea, MT, Watkins, JT, Imber, SD, Sotsky, SM, Collins, JF, et al. National Institute of Mental Health Treatment of Depression Collaborative Research Program. General effectiveness of treatment. Arch Gen Psychiatry1989; 46: 971–82. [Google Scholar](https://scholar.google.com/scholar_lookup?title=National+Institute+of+Mental+Health+Treatment+of+Depression+Collaborative+Research+Program.+General+effectiveness+of+treatment&author=Elkin+I&author=Shea+MT&author=Watkins+JT&author=Imber+SD&author=Sotsky+SM&author=Collins+JF&publication+year=1989&journal=Arch+Gen+Psychiatry&volume=46)

37

37Blatt, SJ, Sanislow, CA, Zuroff, DC, Pilkonis, PA. Characteristics of effective therapists: further analyses of data from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. J Consult Clin Psychol1996; 64: 1276–84. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Characteristics+of+effective+therapists%3A+further+analyses+of+data+from+the+National+Institute+of+Mental+Health+Treatment+of+Depression+Collaborative+Research+Program&author=Blatt+SJ&author=Sanislow+CA&author=Zuroff+DC&author=Pilkonis+PA&publication+year=1996&journal=J+Consult+Clin+Psychol&volume=64) [PubMed](https://www.ncbi.nlm.nih.gov/pubmed/8991314)

38

38Beutler, L, Malik, M, Alimohamed, S, Harwood, M, Talchi, H, Noble, S, et al. Therapist variables. In Bergin and Garfield's Handbook of Psychotherapy and Behavior Change (ed Lambert, M): 227–306. Wiley, 2004. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Bergin+and+Garfield's+Handbook+of+Psychotherapy+and+Behavior+Change&author=Beutler+L&author=Malik+M&author=Alimohamed+S&author=Harwood+M&author=Talchi+H&author=Noble+S&author=Lambert+M&publication+year=2004&pages=227-306)

39

39Moher, D, Schulz, KF, Altman, DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet2001; 357: 1191–4. [CrossRef](https://dx.doi.org/10.1016/S0140-6736(00)04337-3) [Google Scholar](https://scholar.google.com/scholar_lookup?title=The+CONSORT+statement%3A+revised+recommendations+for+improving+the+quality+of+reports+of+parallel-group+randomised+trials&author=Moher+D&author=Schulz+KF&author=Altman+DG&publication+year=2001&journal=Lancet&volume=357&doi=10.1016%2FS0140-6736(00)04337-3)

40

40Dobkin, RD, Allen, LD, Menza, M. A cognitive–behavioral treatment package for depression in Parkinson's disease. Psychosomatics2006; 47: 259–63. [Google Scholar](https://scholar.google.com/scholar_lookup?title=A+cognitive%E2%80%93behavioral+treatment+package+for+depression+in+Parkinson's+disease&author=Dobkin+RD&author=Allen+LD&author=Menza+M&publication+year=2006&journal=Psychosomatics&volume=47)

41

41Blackburn, IM, Davidson, K. Cognitive Therapy for Depression and Anxiety. Blackwell, 1995. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Cognitive+Therapy+for+Depression+and+Anxiety&author=Blackburn+IM&author=Davidson+K&publication+year=1995)

42

42Hampe, M. Pluralismus der Wissenschaften und die Einheit der Vernunft. In Die Erfahrungen, die wir machen, widersprechen den Erfahrungen, die wir haben. Formen der Erfahrung in den Wissenschaften (ed Hampe, M). Duncker und Humblot, 2000. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Die+Erfahrungen%2C+die+wir+machen%2C+widersprechen+den+Erfahrungen%2C+die+wir+haben.+Formen+der+Erfahrung+in+den+Wissenschaften&author=Hampe+M&author=Hampe+M&publication+year=2000)

43

43Lear, J. Open Minded: Working Out the Logic of the Soul. Harvard University Press, 1998. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Open+Minded%3A+Working+Out+the+Logic+of+the+Soul&author=Lear+J&publication+year=1998)

44

44Cicchetti, D, Valentino, K. An ecological-transactional perspective on child maltreatment: failure of the average expectable environment and its influence on child development. In Developmental Psychopathology, Volume 3 (2nd edn) (eds Cicchetti, D, Cohen, DJ): 129–201. John Wiley & Sons, 2006. [Google Scholar](https://scholar.google.com/scholar_lookup?title=Developmental+Psychopathology&author=Cicchetti+D&author=Valentino+K&author=Cicchetti+D&author=Cohen+DJ&publication+year=2006&pages=129-201)

45

45Heim, C, Young, LJ, Newport, DJ, Mletzko, T, Miller, AH, Nemeroff, CB. Lower CSF oxytocin concentrations in women with a history of childhood abuse. Mol Psychiatry2008; Epub ahead of print. [CrossRef](https://dx.doi.org/10.1038/mp.2008.112) [Google Scholar](https://scholar.google.com/scholar_lookup?title=Lower+CSF+oxytocin+concentrations+in+women+with+a+history+of+childhood+abuse&author=Heim+C&author=Young+LJ&author=Newport+DJ&author=Mletzko+T&author=Miller+AH&author=Nemeroff+CB&publication+year=2008)

Submit a response

* * *

## eLetters

No eLetters have been published for this article.

![](data:image/svg+xml;base64,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)You have
Access

19Cited by

* * *

# Cited by

Loading...

![](data:image/svg+xml;base64,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)

Cited by

- ![Crossref logo](https://assets.crossref.org/logo/crossref-logo-100.png)19

- ![Google Scholar logo](https://upload.wikimedia.org/wikipedia/commons/a/a9/Google_Scholar_logo_2015.PNG)


Crossref Citations

[![Crossref logo](https://assets.crossref.org/logo/crossref-logo-100.png)](http://www.crossref.org/citedby/index.html)

##### This article has been cited by the following publications. This list is generated based on data provided by [Crossref](http://www.crossref.org/citedby/index.html).

* * *

Tyrer, Peter
2010.
_The place of theBritish Journal of Psychiatryin the mental health league_.
Epidemiologia e Psichiatria Sociale,
Vol. 19,
Issue. 3,
p.
196.

- [CrossRef](https://doi.org/10.1017/S1121189X00001093)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=The+place+of+theBritish+Journal+of+Psychiatryin+the+mental+health+league&author=Tyrer+Peter&publication_year=2010)

* * *

Tyrer, Peter
2011.
_From the Editor's desk_.
British Journal of Psychiatry,
Vol. 199,
Issue. 5,
p.
438.

- [CrossRef](https://doi.org/10.1192/bjp.199.5.438)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=From+the+Editor's+desk&author=Tyrer+Peter&publication_year=2011)

* * *

DeFife, Jared
2012.
_Horst Kächele, Joseph Schachter, Helmut Thomä, and the Ulm Psychoanalytic Process Research Study Group: From Psychoanalytic Narrative to Empirical Single Case Research: Implications for Psychoanalytic Practice_.
Clinical Social Work Journal,
Vol. 40,
Issue. 1,
p.
112.

- [CrossRef](https://doi.org/10.1007/s10615-011-0322-9)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Horst+Kächele+Joseph+Schachter+Helmut+Thomä+and+the+Ulm+Psychoanalytic+Process+Research+Study+Group:+From+Psychoanalytic+Narrative+to+Empirical+Single+Case+Research:+Implications+for+Psychoanalytic+Practice&author=DeFife+Jared&publication_year=2012)

* * *

Taylor, David
Carlyle, Jo-anne
McPherson, Susan
Rost, Felicitas
Thomas, Rachel
and
Fonagy, Peter
2012.
_Tavistock Adult Depression Study (TADS): a randomised controlled trial of psychoanalytic psychotherapy for treatment-resistant/treatment-refractory forms of depression_.
BMC Psychiatry,
Vol. 12,
Issue. 1,

- [CrossRef](https://doi.org/10.1186/1471-244X-12-60)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Tavistock+Adult+Depression+Study+(TADS):+a+randomised+controlled+trial+of+psychoanalytic+psychotherapy+for+treatment-resistant/treatment-refractory+forms+of+depression&author=Taylor+David&author=Carlyle+Jo-anne&author=McPherson+Susan&author=Rost+Felicitas&author=Thomas+Rachel&author=Fonagy+Peter&publication_year=2012)

* * *

Hoffman, Leon
Algus, Jane
Braun, Will
Bucci, Wilma
and
Maskit, Bernard
2013.
_Treatment Notes: Objective Measures of Language Style Point to Clinical Insights_.
Journal of the American Psychoanalytic Association,
Vol. 61,
Issue. 3,
p.
535.

- [CrossRef](https://doi.org/10.1177/0003065113489026)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Treatment+Notes:+Objective+Measures+of+Language+Style+Point+to+Clinical+Insights&author=Hoffman+Leon&author=Algus+Jane&author=Braun+Will&author=Bucci+Wilma&author=Maskit+Bernard&publication_year=2013)

* * *

Fonagy, Peter
2013.
_There is Room for Even More Doublethink: The Perilous Status of Psychoanalytic Research_.
Psychoanalytic Dialogues,
Vol. 23,
Issue. 1,
p.
116.

- [CrossRef](https://doi.org/10.1080/10481885.2013.754276)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=There+is+Room+for+Even+More+Doublethink:+The+Perilous+Status+of+Psychoanalytic+Research&author=Fonagy+Peter&publication_year=2013)

* * *

Talat, Bilal
Mayers, Andrew
and
Baldwin, David S.
2013.
_Quality of case reports of adverse drug reactions with psychotropic drugs: a 25‐year review_.
Human Psychopharmacology: Clinical and Experimental,
Vol. 28,
Issue. 5,
p.
413.

- [CrossRef](https://doi.org/10.1002/hup.2329)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Quality+of+case+reports+of+adverse+drug+reactions+with+psychotropic+drugs:+a+25‐year+review&author=Talat+Bilal&author=Mayers+Andrew&author=Baldwin+David+S.&publication_year=2013)

* * *

Hoffman, Irwin Z.
2013.
_Response to Fonagy_.
Psychoanalytic Dialogues,
Vol. 23,
Issue. 1,
p.
123.

- [CrossRef](https://doi.org/10.1080/10481885.2013.754280)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Response+to+Fonagy&author=Hoffman+Irwin+Z.&publication_year=2013)

* * *

Taylor, David
Carlyle, Jo-anne
McPherson, Susan
Rost, Felicitas
Thomas, Rachel
and
Fonagy, Peter
2013.
_Chronische Depression_.
p.
268.

- [CrossRef](https://doi.org/10.13109/9783666451683.268)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Chronische+Depression&author=Taylor+David&author=Carlyle+Jo-anne&author=McPherson+Susan&author=Rost+Felicitas&author=Thomas+Rachel&author=Fonagy+Peter&publication_year=2013)

* * *

Wolpert, Lewis
2015.
_Perspective_.
Annual Review of Cell and Developmental Biology,
Vol. 31,
Issue. 1,
p.
1.

- [CrossRef](https://doi.org/10.1146/annurev-cellbio-091614-051122)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Perspective&author=Wolpert+Lewis&publication_year=2015)

* * *

Paris, Joel
2017.
_Is Psychoanalysis Still Relevant to Psychiatry?_.
The Canadian Journal of Psychiatry,
Vol. 62,
Issue. 5,
p.
308.

- [CrossRef](https://doi.org/10.1177/0706743717692306)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Is+Psychoanalysis+Still+Relevant+to+Psychiatry?&author=Paris+Joel&publication_year=2017)

* * *

Longhofer, Jeffrey
Floersch, Jerry
and
Hartmann, Eric
2017.
_A Case for the Case Study: How and Why They Matter_.
Clinical Social Work Journal,
Vol. 45,
Issue. 3,
p.
189.

- [CrossRef](https://doi.org/10.1007/s10615-017-0631-8)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=A+Case+for+the+Case+Study:+How+and+Why+They+Matter&author=Longhofer+Jeffrey&author=Floersch+Jerry&author=Hartmann+Eric&publication_year=2017)

* * *

2018.
_Clinique du seuil_.
p.
163.

- [CrossRef](https://doi.org/10.3917/eres.gasne.2018.01.0163)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Clinique+du+seuil&&publication_year=2018)

* * *

Clarke, Jeremy
2020.
_Some very important people are depressed; get over it!A three-part narrative review of depression memoirs in the public sphere_.
Psychoanalytic Psychotherapy,
Vol. 34,
Issue. 3,
p.
246.

- [CrossRef](https://doi.org/10.1080/02668734.2020.1833965)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Some+very+important+people+are+depressed;+get+over+it!A+three-part+narrative+review+of+depression+memoirs+in+the+public+sphere&author=Clarke+Jeremy&publication_year=2020)

* * *

Kaluzeviciute, Greta
2021.
_Learning from past practices: an overview of criticisms for psychoanalytic case studies_.
The Scandinavian Psychoanalytic Review,
Vol. 44,
Issue. 1-2,
p.
67.

- [CrossRef](https://doi.org/10.1080/01062301.2022.2137313)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Learning+from+past+practices:+an+overview+of+criticisms+for+psychoanalytic+case+studies&author=Kaluzeviciute+Greta&publication_year=2021)

* * *

Ambresin, Gilles
2021.
_Recherche extra-clinique en psychanalyse : cadre conceptuel et exemple de recherche_.
Psychothérapies,
Vol. Vol. 41,
Issue. 4,
p.
187.

- [CrossRef](https://doi.org/10.3917/psys.214.0187)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Recherche+extra-clinique+en+psychanalyse+:+cadre+conceptuel+et+exemple+de+recherche&author=Ambresin+Gilles&publication_year=2021)

* * *

Knafo, Danielle
Oxholm, Birk
and
Snyder, Sara A.
2022.
_In our own words: key terms and trends in psychoanalytic history_.
The American Journal of Psychoanalysis,
Vol. 82,
Issue. 4,
p.
512.

- [CrossRef](https://doi.org/10.1057/s11231-022-09376-5)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=In+our+own+words:+key+terms+and+trends+in+psychoanalytic+history&author=Knafo+Danielle&author=Oxholm+Birk&author=Snyder+Sara+A.&publication_year=2022)

* * *

Kanter Bax, Orestis
Nerantzis, Georgios
and
Lee, Tennyson
2022.
_Transference-focused psychotherapy as an aid to learning psychodynamic psychotherapy: qualitative analysis of UK psychiatry trainees’ views_.
BJPsych Bulletin,
Vol. 46,
Issue. 1,
p.
57.

- [CrossRef](https://doi.org/10.1192/bjb.2020.129)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=Transference-focused+psychotherapy+as+an+aid+to+learning+psychodynamic+psychotherapy:+qualitative+analysis+of+UK+psychiatry+trainees’+views&author=Kanter+Bax+Orestis&author=Nerantzis+Georgios&author=Lee+Tennyson&publication_year=2022)

* * *

Kaya, M. Siyabend
2022.
_The Use of Dynamic Cognitive Behavioural Therapy (DCBT) in Social Anxiety Disorder (SAD): A Theoretical Integration Initiative_.
Medicina,
Vol. 58,
Issue. 12,
p.
1759.

- [CrossRef](https://doi.org/10.3390/medicina58121759)
- [Google Scholar](https://scholar.google.com/scholar_lookup?title=The+Use+of+Dynamic+Cognitive+Behavioural+Therapy+(DCBT)+in+Social+Anxiety+Disorder+(SAD):+A+Theoretical+Integration+Initiative&author=Kaya+M.+Siyabend&publication_year=2022)

* * *

Google Scholar Citations

View all [Google Scholar citations](https://scholar.google.com/scholar?hl=en&lr=&cites=https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/there-is-no-place-for-the-psychoanalytic-case-report-in-the-british-journal-of-psychiatry/959F61577A05256FA6D5F72207EA5E61)
for this article.

×

- [Librarians](/core/services/librarians)
- [Authors](/core/services/authors)
- [Publishing partners](/core/services/publishing-partners)
- [Agents](/core/services/agents)
- [Corporates](/core/services/corporates)

- [Additional Information](#additional)




- [Accessibility](/core/accessibility)
- [Our blog](http://blog.journals.cambridge.org/)
- [News](/core/news)
- [Contact and help](/core/help/FAQs)
- [Cambridge Core legal notices](/core/legal-notices/terms)
- [Feedback](https://www.cambridge.org/about-us/feedback)
- [Sitemap](/core/sitemap)

Choose your location

AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChannel Islands, Isle of ManChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic of theCook IslandsCosta RicaCote D'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-bissauGuyanaHaitiHeard and Mc Donald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian Territory, OccupiedPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSpainSri LankaSt. HelenaSt. Pierre and MiquelonSudanSurinameSvalbard and Jan Mayen IslandsSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic ofThailandTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUnited States Virgin IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands (British)Wallis and Futuna IslandsWestern SaharaYemenZambiaZimbabwe

## Join us online

- [Cambridge Core Facebook(opens in new window)](https://www.facebook.com/CambridgeCore)
- [Cambridge Core Twitter feed(opens in new window)](https://twitter.com/CambridgeCore)
- [Cambridge Core LinkedIn(opens in new window)](https://www.linkedin.com/showcase/11096649)
- [Cambridge Core YouTube(opens in new window)](https://www.youtube.com/playlist?list=PLTK8KRW19hUVucVRHbIx73oLKUro8HXt0)
- [Cambridge Core Instagram(opens in new window)](https://www.instagram.com/cambridgeuniversitypress/)

- [Legal Information](#legal)


- [![Cambridge University Press](/core/cambridge-core/public/images/cambridge_logo.png)](https://www.cambridge.org)


- [Rights & Permissions](https://www.cambridge.org/about-us/rights-permissions/)
- [Copyright](https://www.cambridge.org/about-us/legal-notices/copyright/)
- [Privacy Notice](https://www.cambridge.org/about-us/legal-notices/privacy-policy/)
- [Terms of use](https://www.cambridge.org/about-us/legal-notices/terms-use)
- [Cookies Policy](https://www.cambridge.org/about-us/legal-notices/cookies-policy/)
- © Cambridge University Press 2024
- Back to top

- © Cambridge University Press 2024
- Back to top

Cancel

Confirm

×

# Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below.
[Find out more about saving to your Kindle](/core/help).

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the [Kindle Personal Document Service.](https://www.amazon.com/gp/help/customer/display.html/ref=kinw_myk_wl_ln?ie=UTF8&nodeId=200767340#fees)

There is no place for the psychoanalytic case report in the British Journal of Psychiatry

- Volume 195, Issue 6
- [Lewis Wolpert](/core/search?filters%5BauthorTerms%5D=Lewis Wolpert&eventCode=SE-AU)(a1) and [Peter Fonagy](/core/search?filters%5BauthorTerms%5D=Peter Fonagy&eventCode=SE-AU)(a2)
- DOI: [https://doi.org/10.1192/bjp.bp.109.064451](https://doi.org/10.1192/bjp.bp.109.064451)

Your Kindle email address

Please provide your Kindle email.

@free.kindle.com@kindle.com ( [service fees apply](https://www.amazon.com/gp/help/customer/display.html/ref=kinw_myk_wl_ln?ie=UTF8&nodeId=200767340#fees))

Available formats PDF
Please select a format to save.

By using this service, you agree that you will only keep content for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services
Please confirm that you accept the terms of use.

Cancel

Save

×

# Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account.
[Find out more about saving content to Dropbox](/core/help).

There is no place for the psychoanalytic case report in the British Journal of Psychiatry

- Volume 195, Issue 6
- [Lewis Wolpert](/core/search?filters%5BauthorTerms%5D=Lewis Wolpert&eventCode=SE-AU)(a1) and [Peter Fonagy](/core/search?filters%5BauthorTerms%5D=Peter Fonagy&eventCode=SE-AU)(a2)
- DOI: [https://doi.org/10.1192/bjp.bp.109.064451](https://doi.org/10.1192/bjp.bp.109.064451)

Available formats PDF
Please select a format to save.

By using this service, you agree that you will only keep content for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services
Please confirm that you accept the terms of use.

Cancel

Save

×

# Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account.
[Find out more about saving content to Google Drive](/core/help).

There is no place for the psychoanalytic case report in the British Journal of Psychiatry

- Volume 195, Issue 6
- [Lewis Wolpert](/core/search?filters%5BauthorTerms%5D=Lewis Wolpert&eventCode=SE-AU)(a1) and [Peter Fonagy](/core/search?filters%5BauthorTerms%5D=Peter Fonagy&eventCode=SE-AU)(a2)
- DOI: [https://doi.org/10.1192/bjp.bp.109.064451](https://doi.org/10.1192/bjp.bp.109.064451)

Available formats PDF
Please select a format to save.

By using this service, you agree that you will only keep content for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services
Please confirm that you accept the terms of use.

Cancel

Save

×

×

#### Reply to:Submit a response

Title \*
Please enter a title for your response.

Contents \*Contents help

Close Contents help

\- No HTML tags allowed

\- Web page URLs will display as text only

\- Lines and paragraphs break automatically

\- Attachments, images or tables are not permitted

Please enter your response.

* * *

#### Your details

First name \*
Please enter your first name.

Last name \*
Please enter your last name.

Email \*Email help

Close Email help

Your email address will be used in order to notify you when your comment has been reviewed by the moderator and in case the author(s) of the article or the moderator need to contact you directly.

Please enter a valid email address.

Occupation
Please enter your occupation.

Affiliation
Please enter any affiliation.

* * *

##### You have entered the maximum number of contributors

* * *

#### Conflicting interests

Do you have any conflicting interests? \*
Conflicting interests help

Close Conflicting interests help

Please list any fees and grants from, employment by, consultancy for, shared ownership in or any close relationship with, at any time over the preceding 36 months, any organisation whose interests may be affected by the publication of the response. Please also list any non-financial associations or interests (personal, professional, political, institutional, religious or other) that a reasonable reader would want to know about in relation to the submitted work. This pertains to all the authors of the piece, their spouses or partners.

Yes
No

More information \*
Please enter details of the conflict of interest or select 'No'.

* * *

Please tick the box to confirm you agree to our [Terms of use](/core/legal-notices/terms). \*

Please accept terms of use.

Please tick the box to confirm you agree that your name, comment and conflicts of interest (if accepted) will be visible on the website and your comment may be printed in the journal at the Editor’s discretion. \*

Please confirm you agree that your details will be displayed.

* * *