Psychoanalysis as a theory of therapy

The development of psychoanalytic theory is traced from its origins in Freud's early thinking in terms of his advancing clinical experience. While the influence of clinical experience on the modifications of theory has long been accepted, little attention has been paid to the broad spectrum effects of changing theoretical perspectives on the technique of clinical psychoanalysis. This development is traced through the emergence of ego psychology and the dominance of the structural theory to more current developments having to do with object relations and the theory narcissism. The residual theoretical ambiguities and clinical perplexities are illustrated in two clinical cases. The development of psychoanalytic theory and the correlative aspects of technique are seen as manifesting an organic developmental process which has led to an increasing sophistication of analytic intervention and a broadening capacity for dealing with increasingly difficult and less classical types of cases. The conclusion is drawn that therapeutic lestening is equivalently an informed listening, and it is theory that lends understanding and sensitivity to the hearing process. It is theory that is to be put in the service of listening, rather than listening to be put in the service of theory.