Many new perspectives have emerged in the century since psychoanalysis was conceived. Emphasis has shifted from the intrapsychic to the interpsychic and interpersonal. Kleinian psychoanalysis offers a unique vision of the ways in which interpersonal reality is inescapably coloured by the emotional state of the participants. Attachment theory has begun to provide an account of human psychological development that both takes account of meaning and is empirically based. Psychoanalysis is emerging from its isolation and bridges have begun to be built with cognitive science: the inner world of phantasy is not unlike the world of schemata and assumptions that are the focus of cognitive therapy. There are, through modern neuroimaging techniques, even links being forged with neurobiology: we can now see the impact of effective therapeutic interventions on brain architecture. Progress will depend on further theoretical syntheses and technological advances, while holding firm to the humanistic emphasis on personal meaning and inner experience that is the fundamental contribution of psychoanalysis to contemporary psychiatry.

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