Where Have All the Psychoanalytic Patients Gone? They're Still Here

Abstract

I develop my argument concerning the question of where have all the patients gone in a sequence of three parts. First, I indicate, very briefly, the nature of the issue and the array of confluent socioeconomic causes—as they are usually outlined—that are held responsible for it. Then I take up the remedy for this problem posed by Arnold Rothstein in his book (1998). which is the trigger to this series of invited commentaries, and I indicate how I both appreciate the merits of his proposal to recast the issue as much as possible within a psychological framework, amenable to psychoanalytic influence, and nonetheless feel his approach to be based on a one-sided, and to that extent, a limited and flawed assessment of the problem, and therefore an only partially useful remedial perspective. And lastly, 1 offer an alternative view of the internal historical developments in psychoanalysis that have played their complementary role in the evolution of this perceived “crisis” and the alteration of perspectives, based on my account of our contending current viewpoints on the nature of the relationship between psychoanalysis and its derivative psychoanalytic psychotherapies, that can perhaps promise a more effective counter to the crisis, despite the multiple external socioeconomic developments that are usually accorded causative primacy and that no doubt are indeed formidable.