HOW DO WE KNOW WHAT IS TRUE

A patient is presented who was treated with reasonable success as an a dolescent, but who then returned to treatment as an adult with a clear failure resulting. Some reasons for the failure are suggested, and so me alternative courses of action are suggested. The issue of the compe ting demands of the reality of the patient and a more consensually acc epted reality is central to the case, and poses difficult decisions fo r the therapist.