Specificity Theory: The Evolution of a Process Theory of Psychoanalytic Treatment

The author summarizes the perspectives of specificity theory and personal and professional experiences that led to its development. Specificity theory is a contemporary process theory of therapy that holds that each analyst-patient dyad constitutes a unique, reciprocal system, challenging us to reconsider how psychoanalytic therapy is optimally practiced and taught. Therapeutic possibility is co-created in the specificity of fit between the patient's particular therapeutic needs and that therapist's capacity to respond to them, both of which will emerge and change within the unique process of each particular dyad. Specificity theory recognizes that what each therapist effectively offers a particular patient may include but will also transcend considerations of formal theory and its prescribed technique. Evolving against the backdrop of the innovative thinking of Sándor Ferenczi and from the author's personal work with Michael Balint, Wilfred Bion, Donald Winnicott, Marion Milner, and Heinz Kohut, its perspectives are corroborated within contemporary neurobiology, preeminently in the work of Gerald Edelman, and by infant researchers, such as Louis Sander, Ed Tronick, and Karlen Lyons-Ruth.