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Witenberg, E.G. (1987). Clinical Innovations and Theoretical Controversy. Contemp. Psychoanal., 23:183-198.

(1987). Contemporary Psychoanalysis, 23:183-198

Clinical Innovations and Theoretical Controversy

Earl G. Witenberg, M.D.

I WANT TO PRESENT MY OBSERVATIONS on the relationship between theory and practice as the result of having been in the field for 39 years and six months. The context within which I present this, of course, is as a member of an Institute which has had, and continues to have, an open-ended approach to both theory and practice. The assumption is that the final answer is not in; we do not have the final theory or the final way to practice. We know that we help people who come to us. We are only on the verge of knowing how this help works.

As a result of the open-ended approach I think I have come to understand almost all theories. My position is: I love all theories but I fall in love with none of them. When I study theories, I feel enlightened and get clearer about my premises. I find a theory particularly helpful when I can say, "Yes, of course. That's true. I have never put it into words before." The theorist had been able to identify and put into syntactic form something that was unformulated or inattended by me. I find theories which increase the complexity of psychic structure without increasing my clinical knowledge a problem because I get bored. Taxonomy was never my favorite subject; clinical work is.

I feel I can use whatever help I can get when I see a patient. For example: On her third visit a professional woman of 35 tells me that a year ago she had the following two dreams on the same night. (1) She is in the third floor bathroom of her childhood home (her own room is next door); it is a bathroom with a claw-footed tub, a toilet, and a window overlooking the second-story roof. She has her back to the window, facing the door. In walks her four-year-old self with an arrogant look on her face. She, the adult, becomes frightened, takes something (a pillow?), and throws it at the four-year-old.

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