Methodology and reconstruction

The challenges presented in treating patients with so-called borderline and narcissistic personality disorders have revived interest in the subject of reconstruction, because many analysts believe that these difficulties originate in the events of the earliest preverbal phase of development. They feel that contributions from direct observation of neonates and knowledge gained from "infant psychiatry" may enable analysts to effect reconstructions that previously appeared to be only speculative. The methodological problems in applying this approach, however, may lead to foisting upon clinical observation preconceived paradigms of pathogenesis. Reconstruction depends upon a disciplined interpretation of the dynamic record of the patient's associations, which demonstrate how the past is embedded in the present. The validity of the reconstruction depends upon the application of appropriate and disciplined psychoanalytic methodology. Reconstructions constitute a special form of interpretation and are part of the psychoanalytic process.