In Wallang's tour de force ^{Reference Wallang1} (history of Western philosophy in four pages) arguing for a narrative-based approach to psychiatric consultation, there was a striking omission: nowhere was psychodynamic/psychoanalytic psychiatry mentioned. Yet this etiolation of psychodynamics underpins the aridity of diagnosis-focused psychiatry that he bemoans.

Psychodynamic approaches enlarge semiotic space in two main ways. ^{Reference Holmes2} First, they bring into the field all the communications - verbal and non-verbal, conscious and unconscious - that arise between patient and professional, not merely stated symptoms. Wallang himself illustrates this via his ‘noticing’ his patient's diagnostically ‘irrelevant’ Taoist bedside reading; this brought into focus a different, non-pathological dimension of the patient's life. Second, they offer a set of developmental meanings which help understand how it is that this individual finds herself or himself in this particular dilemma at this particular juncture in her or his life. Wallang's ‘personal meanings’ are invariably illuminated by this developmental perspective. His last-ditch drug-addicted patient who found solace in the thought that there is ‘motion in inertia’ might be referring to a childhood experience of a depressed ‘inert’ mother, his own ‘motions’ (pleas for attention?, ‘shitty’ feelings?) towards her, and the later discovery of drugs as a short cut to assuagement of longing.

Was Wallang's lacuna tactical (don't frighten the horses) or technical (psychodynamics still not fully evidence-based)? Either way, despite this conspicuous absence, his piece was a welcome change from standard psychiatric journal fare.