Frederick Crews makes a number of basic factual errors in his "triumphalist" critical attack on psychoanalysis.

First, he makes the absurd assumption that clinical psychoanalysis has not changed since Freud's day, and that Freud's specific clinical failures, or his adhesion to 19th-century psychiatric practices, somehow vitiate current psychoanalytic work with mental disorders. Psychoanalytic clinical work has developed such a distance from Freud, and has also vitally influenced other related forms of therapy such as counselling and psychoanalytic psychotherapy, that the idea that any supposed "truths" about the Eckstein or Frink cases might fatally compromise these professions is patently deluded.

In this context, too, his claim that ". . . no uniquely psychoanalytic notion has received independent experimental or epidemiological support" is quite amazing.

If he is talking about diagnostic categories, then a brief glance at any of the main diagnostic axes of the new Diagnostic and Statistical Manual of Mental Disorders (DSM4) clearly indicates the strong presence of psychoanalytic categorisation, particularly in areas of mental disorder where psychoanalytic psychotherapy remains a recommended form of treatment, namely anxiety disorder, brief reactive disorders, stress disorders, and somatoform or conversion disorders.

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In each of these axes, extensive outcome studies have been carried out which indeed have led to increased funding for counselling and psychotherapy within national health services.

If Crews is talking about the use-value of specific clinical terms, then just the two notions of autoplastic and alloplastic function (concerning respectively the internal and agency response of the body to trauma) suffice to illustrate the central involvement of psychoanalysis in general clinical work.

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Even more surprising, given Crews's location in an English department in a university, is the idea that psychoanalysis remains primarily a clinical practice, as opposed to a broad cultural critique based on specific approaches to language, discourse and representation.

Crews's claim that psychoanalysis has remained "a psychology for the others, not for the interpreter him or herself", seems totally ignorant of the extensive long-term debate around the concept of countertransference, which raises precisely the issue of the analyst's unconscious implication in the analytic process, as well as in the status of the supposed "knowledge" produced.

MARTIN STANTON

Director

Centre for Psychoanalytic Studies

University of Kent