place in an arena where the relationship between two people is the central element. This fact alone introduces so many variables that any notions of standardised processes and predictability of results becomes inapplicable to our work, whether we think this is a loss or not.

Similiary, analytic work is done in large part by the patient; its starting point is the appeal by the patient for help and the patient’s motivation and willingness to make the work 'work' are central to its outcome. This is not an apology for the shortcomings of the therapist, but a statement of a sine qua non of this type of work. The complexity and, indeed, the division of the person’s motivations entail that the wish of the patient to gain insight, to move in a new direction, and even to ‘get better’ cannot be taken for granted. The analytic concept of resistance recognises the central place in our lives of the

passion we all are capable of displaying for suffering, ignorance and destruction.

In what ways does psychoanalytic psychotherapy differ from other therapies?

Psychoanalytic work differs from many other therapies in three main ways:

• The place of knowledge


• The position of the analyst vis-a-vis the ‘complaint’ of the patient


• The consequences regarding the framework in which the work takes place

Whilst psychoanalytic therapists may know a great deal about a number of things, amongst them, of course, psychoanalysis and aspects of psychology, the place this type of knowledge plays in the actual clinical process is very limited. For instance, the analyst has a fair understanding of ‘how the

unconscious works’ but, to begin with, no idea whatsoever as to what is ‘in’ the patient’s unconscious mind. He or she may know a lot about ‘human development’ but nothing about this particular patient’s early history. Furthermore, whilst ideas about ‘mental health’ abound, the analyst refrains from assuming to know what it is good for the patient to do, to think, to feel, to believe in, etcetera. Having undergone a prolonged period of self-exploration and self-questioning (personal analysis being a training requirement which sets psychoanalysis fundamentally apart from the therapies which are branches of psychology), they are likely to have acquired a deep appreciation that to live a life as a sentient human being is an endeavour of considerable complexity. Who would want to claim to be an expert in living life, one’s own life, let alone anyone else’s? In contradistinction to other therapies which are in the ascendency today,