Interpreting Interpretation

Interpretation of the latent meaning of manifest content is the core of the traditional approach to psychoanalytic treatment. The main purpose of such interpretation is to enhance the patient's self-knowledge, in particular his or her awareness of unconscious wishes and their embeddedness in inner conflicts. An assumption of classical psychoanalysis is that veridical interpretations-as Freud put it, interpretations that tally with what is real in the patient-will be especially effective therapeutically. These basic assumptions have been called into question, as reflected in such concepts as "narrative truth" and the overriding importance of the patient's "assured conviction" regarding interpretations. Also called into question is the therapeutic value of "deep" interpretations intended to uncover repressed impulses. To an important extent, these have been replaced by interpretations of defensive processes just below the surface of consciousness, and interpretations that make connections among different experiences, both of which are intended to help the patient understand how his or her mind works. There is also an increased emphasis on nonsemantic aspects of interpretation, as well as some degree of skepticism toward the therapeutic value of interpretation itself, along with an increased emphasis on the implicit interpretive aspects of the therapeutic relationship. Finally, representative research is presented on the relation between transference interpretation and therapeutic outcome.