The psychoanalytic process and analytic inference: a clinical study of a lie and loss

The nature of analytic evidence derived from the analytic process is illustrated and reviewed. The initial acting out of flight from analysis concomitant with an egregious lie later surprisingly proved to be analysable. The lie of loss was a leitmotiv in the analysis which revealed a neurotic structure strongly influenced by actual and threatened traumatic parent loss in childhood. Analytic explanation of psychopathology and pathogenesis is based on insightful inference at increasing distance from the direct analytic data. The meanings inferred and understanding achieved are progressively refined to minimize suggestion and subjectivity. Clinical inference may be tested in the analytic process, but inferences concerning the distant past, or on higher levels of abstraction or generalization require consistency and coherence and articulation with analytic knowledge and principles. The reconstruction of traumatic experience is re-emphasized as a significant dimension of analytic work, with reciprocal illumination of transference and resistance. In the case presented the evidence was drawn from the totality of the analytic process, in which shared inferences become a part of the process in which they are further evaluated and extended.