The Psychodynamic Formulation of Conflict

Bridging the gap between theory and practice is one of psychiatry’s most important tasks. Although theories abound, too often there is only meager evidence to support those theories. Paradoxically, the overwhelming material which some patients bring to an interview presents a serious problem for the psychiatrist, who must order the abundant, seemingly chaotic content into intelligible conceptual form. Moreover, in bringing clinical content into closer relationship with theoretical conclusions, the distinction between what the patient talks about and what the doctor infers is sometimes overlooked. It is possible to slip from cautious inductive reasoning to deduction from already established hypotheses, without recognizing that new factors have been introduced. The resulting confusion between theoretical conjecture and clinical facts has even prompted some psychiatrists to believe that they have made unique discoveries.

The current popularity of the tape-recorded interview is based on