ON THE ASTONISHING CLINICAL IRRELEVANCE OF

The clinical work of psychoanalysts can be thought of in both a narrow and a broad sense. In the narrow sense, it refers to what is commonly thought of as psychoanalytic technique, the methods analysts use to understand their patients and to convey that understanding to them. In the broad sense, it refers to the entirety of their work as clinicians: the content of understanding, as well as such things as diagnosing, estimating analyzability, recommending therapy, and prescribing medication. The current enthusiastic expectation that neuroscience will have an immediate and direct impact on clinical work in the narrow sense is misguided, but neuroscientific discoveries, it is argued, will have a major impact on psychoanalytic theory in the not too distant future. The resulting changes in metapsychology will ultimately have reverberations on clinical work in the broad sense, although psychoanalytic technique, the analyst’s basic approach to patients, will remain essentially the same. L et me begin with a word about my title. Judging from the laugh-ter and rolled eyes I encounter when I read the title to my friends, I suspect that it might be a little controversial. However, I like contro-versy, and, having had long experience with the soporif ic effect of plenary addresses, I wanted to be sure that at least in the beginning I had everybody’s attention. Those of you who are hoping to hear a diatribe against neuroscience are, I’m afraid, going to be disappointed. This is a pro-neuroscience paper. My overall aim is threefold. First, I want to temper some of the overexpectation that tends to be stirred up by the neuroscientif ic papers appearing these days in the analytic literature. These papers often imply that neuroscience will in some way change our daily psychoanalytic technique, an implication I conside