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With apologies offered variously to Jack Benny and Zero Mostel, I'm going to begin this chapter with a story that might be called "A Funny Thing Happened to My Title on the Way to the Conference"— a story that turned out to be an unanticipated example of how I see the issue of clinical judgment. What constitutes sound "clinical judgment" is of course inevitably arrived at by hindsight: an analyst presents clinical material at a meeting and defines it as what he did, and the discussant (no matter how sophisticated his efforts at tactfulness) defines it as what it might have been better to do. However, when I recently received my copy of a conference program (see n. 1), I discovered that the title of the paper I was scheduled to present as part of a panel on clinical judgment was listed as "Staying Sane While Changing," not, in fact, the title I had submitted. Someone had already been exercising clinical judgment! In my fantasy the "som eone" was a copyeditor who found paradox difficult
1. This chapter revises and expands a paper presented as part of a panel on "Relational Aspects of Clinical Judgment" at the 1996 spring meeting of the Division of Psychoanalysis (Div. 39) of the American Psychological Association. The original version was published in Psychoanalytic Dialogues, 1998, 8:225-236.