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Silverman, D.K. Gruenthal, R. (2008). Enhancing Clinical Analytic Work. Psychoanal. Rev., 95(5):819-843.

(2008). Psychoanalytic Review, 95(5):819-843

Enhancing Clinical Analytic Work

Doris K. Silverman, Ph.D. and Ruth Gruenthal

Controversies abound in our field and often obscure the potentially important and useful features when presented only in their divisive polarities. It is typical when advocating for a particular position to present the other side in an extreme, often mockingly derisive way, so that it is unrecognizable by its advocates. Such divisions do not enhance the growth of our knowledge and this certainly applies to efficacy and effectiveness in the therapeutic process. This paper advocates for an amalgam of both empirical and clinical work as an effective path for advancing our knowledge and clinical practice. Specifically, we present tacitly assumed experimental information that is often in the background of clinicians' thought, as well as, the explicit use of available experimental research. A recognition of the presence of both in our thinking and our therapy can enhance our clinical skills. Whereas our clinical expertise is central to our therapeutic functioning, an amalgam of clinical knowledge with both implicit and explicit empirical information can further our ability to address important issues. Here we are thinking about which kind of treatment, for which patients, and as guided by the knowledge of the most effective interventions.

There are indeed controversies that fragment our field and do not enhance our therapeutic effectiveness. One such rift is a clinical versus empirical view of practice. Clearly a number of important factors produced such a division both reasonable and less so.

Whittle (2000), cited in Luyton et al. (2006), has argued “every belief and assumption of the other side appears so wrong, as well as so irrelevant, that even when motivated, one side quickly loses interest in the other's literature.

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