Doctor knows best

Therapy wars: the revenge of Freud is a fascinating Long Read in today’s Guardian. It is a very readable analysis by Oliver Burkeman of the arguments, claims and counter-claims advanced on the one hand by psychologists and on the other by therapists, of the benefits and efficacy (or otherwise) of psychoanalysis and various alternative approaches to therapy, in particular cognitive behavioural therapy (CBT).

I was particularly struck by this,

David Pollens, in his Upper East Side consulting room, said he had some sympathy for the “dodo-bird verdict”[the idea, supported by some studies, that the specific kind of therapy makes little difference], despite his passion for psychoanalysis. “There was a wonderful British analyst, Michael Balint, who was very involved in medical training, and he had a question he liked to pose [to doctors],” Pollens said. It was: “‘What do you think is the most powerful medication you prescribe?’ And people would try to answer that, and then eventually he’d say: ‘the relationship’.”

My father was a GP in a small market town in the second half of the last century. He would have entirely agreed with Michael Balint. He always maintained that many of the people he saw in his surgery wanted nothing more than the opportunity to sit down with their doctor and tell him or her what was troubling them. For him the relationship he had with his patients was all.

A father’s grief

Listening to Mohammed Al Fayed, one’s first reaction is that the man is mad. You only have to read the report on the BBC News website.

But the man is mad with grief: “Those who mourn may mimic madness to the observer’s eye” [Freud, ‘Mourning and Melancholia’, in Complete Psychological Works of Sigmund Freud, vol. xiv (1914 – 16), (Hogarth)].

He wants the world to know what he thinks is the truth, but my only feeling is that there is something almost indecently voyeuristic in the reporting of the Diana inquest, and in our obsession with the events of a decade ago. Enough truly is enough: it is not the cost, the huge fees being earned by people who should know better, the titillation, the toe-curling revelations from the likes of Paul Burrell. It is, rather, seeing a deeply unsympathetic character, the pantomime villain, gripped by a madness that there but for the grace of God each one of us may suffer.