Abstract
There is mounting pressure on long-term psychotherapy to justify itself. While not discounting its importance, we should remind ourselves that the economic dimension which has dominated much of the debate is only one aspect of this serious professional issue. Ethics, effectiveness, and the dangers, side-effects and short-comings of treatment also merit close consideration. So to do the underlying assumptions, both implicit and explicit, about the nature of people and of mental disorders, about the nature of science and knowledge and about the tension between causes and meanings in the construction of knowledge in psychiatry.