ABSTRACT

Psychotherapy can be seen as a branch of social psychiatry, using psychological methods to reverse or mitigate the damaging effects of environmental failure. This immediately raises two questions. First, given that the damage is already done, how can mere talk undo past miseries? Second, since many people resiliently survive unhappy childhoods without developing psychiatric disorder, are therapists justified in attributing present difficulty to previous trauma? The two quotations from Bowlby above illustrate the transition between his career as a clinician and psychoanalyst to that of a researcher and theorist. The therapist, faced with the patient in front of him, naturally attributes his difficulties to the history of environmental failures he recounts. The researcher, with a control group and a sense of a population at risk rather than just one individual, is forced to more cautious conclusions.