Formulating interpretations in clinical psychoanalysis

The psychoanalytic psychology of the self led not only to a theoretical expansion of our central concepts of transference and resistance, but it also led to a decisive, dual shift in the manner in which we formulate and focus our interventions, irrespective of the nature of the patient's psychopathology. What we have described here as the empathic, reconstructive-interpretive process, and have exemplified with a clinical vignette, bridges within the psychoanalytic process the often still prevailing sharp division between conflict-based, structural psychopathology and deficiency-based, primary self-pathology. The utilization of a predominantly empathic mode of listening and responding (as contrasted with a predominantly inferential mode) is of particular significance in unifying the psychoanalytic approach to the various forms of psychopathology. Empathic reconstructive-interpretations encompass both transference repetitions and new experiences. Such interventions, therefore, responded to the total self of the patient, rather than to isolated, single elements in his associations and thereby lend them their broad therapeutic leverage.