Women and Children Last

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Notes

In this paper I have found it useful to distinguish between psychoanalytic and psychodynamic psychotherapeutic interventions, not on the basis of the technique employed, but rather on the basis of the analyst's intentions and the use to which the patient puts the treatment. I use the term “psychoanalysis” (or “analysis”) to refer to interventions aimed at liberating the analysand from interferences of self-knowledge and spontaneous development. I use the term “psychotherapy” for any form of talking therapy. “Psychodynamic psychotherapy” is simply psychotherapy based on psychodynamic principles. I believe that clearly distinguishing between psychoanalysis and psychodynamic psychotherapy— even though the two are often mixed in clinical work and even though making the distinction can lead to confusion, since other analysts using the same words make distinctions on very different bases, such as the frequency of sessions—introduces a useful and significant terminology for the purposes of the discussion that follows. Maintaining the distinction is important because the belief that most children are unable to do analytic work is the primary reason given for substituting psychotherapy for psychoanalysis with them.

The actualities of so-called “child protection” services are even more problematic because relevant laws and policies combined with inadequately trained and overextended workers often means that, as actually implemented, laws intended to protect children place horrendous burdens on the children themselves.

This kind of thinking, that insofar as individuals are childlike they are limited and defective, works its way subtly into psychoanalytic theory, with the notion that psychopathology commonly represents immature development. Beginning with Freud, psychoanalysts recognized that psychopathology in the sense of psychological distress often is the result of disturbed development. This observation subtly morphed in the course of psychoanalytic thinking to a logically quite different idea, that developmental immaturity in and of itself constitutes psychopathology regardless of whether that immaturity has problematic results.

Many years later an adult psychotherapy program was begun at the institute with much less rigorous requirements, which in fact offered training that was not comparable to analytic training, although it too was designed to bring non-physicians closer to the analytic fold.

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Notes on contributors

Robert M. Galatzer-Levy

Robert M. Galatzer-Levy is Clinical Professor of Psychiatry and Behavioral Neurosciences at the University of Chicago. He is a faculty member of the Chicago Institute for Psychoanalysis, where he is a Training, Supervising, and Child and Adolescent Supervising Analyst.