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Miller, J.P., Jr. (1991). Chapter 4 Can Psychotherapy Substitute for Psychoanalysis?. Progress in Self Psychology, 7:45-58.

(1991). Progress in Self Psychology, 7:45-58

Chapter 4 Can Psychotherapy Substitute for Psychoanalysis?

Jule P. Miller, Jr., M.D.

Shortly after becoming a candidate, I read several papers published in the Journal of the American Psychoanalytic Association (1954) dealing with the question of the similarities and differences between psycho-analysis and psychotherapy. I remember well my reaction. The papers that I read, by Gill, Rangell, and Stone, each found grounds for sharply separating psychoanalysis from psychotherapy — for making a qualitative distinction between the two. I read the papers rather hastily and remember thinking that the authors were twisting themselves into pretzels intellectually in an attempt to establish a spurious position. It seemed clear to me that there was a continuum from the less intense forms of psychotherapy to the most rigorous psychoanalysis, and I felt that the authors were reaching in an artificial way in their attempts to establish a qualitative difference. I thought that perhaps they were doing so for reasons of empire building or establishment of guild solidarity.

After many years of experience doing both analysis and therapy, I continue to believe that they are on a continuum and that there is no sharp dividing line either in theory, technique, goals, or results between psychotherapy and psychoanalysis.

However, in preparation for this chapter, I reread the contributions of Rangell and Gill and found them valuable. I believe my original judgments were too harsh, perhaps colored by my youth.

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