Special Clinical Commentary

CLINICAL COMMENTARY XXVII:BBC PROGRAMME - THE TALKING CURE

In this issue we present a clinical commentary on the first film of the 1999 BBC series TheTalking Cure. Based on work at the Tavistock Clinic, the first film presented an accountof a four-session assessment conducted by Caroline Garland from the Tavistock TraumaUnit of Jan Gale who, in 1991, had been involved in a motor accident which resulted inthe death of the other motorist.

The decision of the Tavistock to allow the BBC to film its work raises questions in theminds of many clinicians about confidentiality and violation of the safety of the consultingroom. However, we need to be reminded that the family therapists have been usingvideotaped sessions for training and for conference presentation for many years.

The filming of Caroline Garland's assessment sessions with Jan Gale gives thepsychotherapeutic community a chance to see with its own eyes so to speak what thesesessions were like. But, as our commentators emphasize, we must recognize that what wesee is no less a construction than any other processed version of a therapy session. TheBBC has edited its footage to create what the film-makers feel will be a watchable, livelyprogramme. As such our clinical commentaries are commentaries on what we are shown,not necessarily on what `really' happened in this therapeutic dyad.

Many readers will have had strong professional reactions to the BBC's representationof Garland's sessions, both positive and negative. However, it is vital that psychotherapybegin to move beyond strong reactions to begin to formulate principled criticisms and self-criticisms of our theories and practices. We have asked three experienced clinicians toexpress their thoughts on these sessions as a way to further constructive engagementbetween different points of view and orientations.

Although the commentators range in opinion about the effectiveness of the assessmentsessions, there is broad agreement on the importance of the major clinical issue thatappears in these sessions: the question of how to relate to defences. As a professionalcommunity we may all wish to reflect on what our respective theories and clinicalexperiences tell us about the timing, effectiveness or desirability of challenges to a defencestructure. We might further want to reflect on how we might engage productively withcolleagues of differing views from our own.

Joseph Schwartz

COMMENTARY BY AN OBJECT RELATIONAL PSYCHOTHERAPIST

Neither psychotherapy nor psychoanalysis are spectator sports. Any attempt to show themtelevisually suffers from the need to dramatize and narrate what is essentially an untidyprocess involving at one moment the search for understanding, at another the tolerance forconfusion, at another the ability to track the nuance of feeling, the scrutinizing oftransference-countertransference dynamics and what, to the untrained