Theoretical plurality and pluralism in psychoanalytic practice

The author begins by characterizing the present situation of psychoanalysis as one of increasing theoretical and practical diversity. The aim of this paper is to consider in depth the impact of theoretical plurality on clinical practice. After noting that the analyst has much more than evenly suspended attention in his(2)mind as he works with his patient in a session, the author reviews both older and more recent contributions on what the analyst has in his mind when working with a patient. He suggests that the subject has been addressed mainly from a single-person perspective. In this connection, and on the basis of clinical material, he attempts to show how, against the background of the 'implicit use of explicit theories', an ongoing process of decision-making that is co-determined by the patient's action and reaction takes place in the analyst's mind. In his analysis of a session, the author introduces the concepts of theoretical reason and practical reason, and contends that, whatever theories the analyst may have implicitly or explicitly in his mind, they ultimately yield to practical reasons. Pursuing the same line of thought, he describes validation in the clinical context as a single, wide-ranging, continuous process of social and linguistic co-construction of the intersubjective reality between patient and analyst. This process includes mutual aspects of observation and of communicative and pragmatic validation. In conclusion, he suggests that the figure of the craftsman is an appropriate description of the analyst in this conception of his work.