On the limits of psychoanalytic theory: a cautionary perspective.

Citing the complexities of the human mind with respect to early development and its functioning in later life, the author cautions against the reliance on any individual psychoanalytic theory in clinical work. Psychoanalytic theories, in general, do not take into account many factors such as the patient's constitutional givens, his or her inborn temperament, family system factors, the impact of the autonomous functions on development, the limits of the child in Piagetian terms, or post-oedipal learning. The analyst's favorite theory may become a belief system that shapes his or her understanding of the patient leading to an imposition of the theory on the data. The analyst's sense of certainty about his or her favorite theory may be based on a transference to the author of the theory or from its fit with his or her own psychological makeup. Cited is Greenson's position (1969/1978) that if he tries to imagine an analytic session with a "true believer" analyst repeating the catechism of his school, he would find it "hard to see this as a living creative experience for either the patient or the therapist" (p. 354). Ultimately, not accountable in terms of any psychoanalytic theory, there is something ineffable, which is the persistent and basically indestructible essence of the person that cannot be explained on the basis of good mothering or on the basis of a facilitating environment. Whether this is thought of as "soul" or "spirit," or even a Winnicottian "true self," it is not something the psychotherapist can omnipotently create. It can only be discovered - unearthed, unburied, cleared away of emotional clutter.