ABSTRACT
My answers to the question of whether psychotherapy and psychoanalysis are the same or different are inconsistent, depending on who is asking and why. To those who already believe that they are different, I usually go to great lengths to describe the difficulty in proving that difference, and assert all the advantages of blurring that difference.To those who are sure that they are the same, I happily drag out all the answers that prove the reverse. I think I am not just being contrary or Talmudic. Rather, the question does not have a simple answer at this time, and so it is better to recognize the advantages and disadvantages of each point of view. Certainly, the question has generated important discussion, along with lots of poorly founded certainty and defensiveness. I do, however, hold to a firm belief in all of these discussions; whether or not psychoanalysis is more like psychotherapy or more different from it, there is such a thing as psychoanalysis, and its practice, if not its ideas, is relatively fragile and needs protection both from its excessively zealous supporters who might strangle it in their loving grasp, and from its vehement detractors who would prefer that it disappear. Furthermore, the external cultural influences are not always friendly to psychoanalysis – whether in the form of insurance companies, governmental regulations, competing therapies, or popular culture – and so some of us have to be ready to support psychoanalysis unless we come to the conclusion that it doesn’t merit our blessing.The topic, therefore, in addition to being clinically and theoretically important, is at least in part political and it always was.The question of whether psychoanalysis and psychotherapy are the same or different involves issues of money, status, social class and elitism, in the perception of both
our patients and ourselves.This inescapable political dimension to the topic colors the discussion.
