ABSTRACT
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 “someone” was a copyeditor who found paradox difficult to appreciate. I could imagine the copyeditor looking at my actual title, “Staying the Same While Changing,” and saying to himself, “Bromberg couldn’t really have meant that. A patient can’t both stay the same and change. Ah, I know. I’ll bet the title is ‘Staying Sane While Changing,’ and his secretary misheard him.”
