Conceptualisation of clinical facts in the analytic process

In this paper the author discusses what she understands to be a clinical fact, stressing that it takes place within the analytic situation between patient and analyst. It is in the process of conceptualising the fact that the analyst comes to define it. In order to conceptualise, the analyst must have a frame of reference, a theoretical basis through which he perceives his patient's communications and is able to give meaning to them. In analytic work, the analyst uses his theory in mainly two ways. When working with his patient it operates mostly unconsciously, but interspersed by quick more conscious thinking. When away from the patient, theory needs to come to the front of the analyst's mind, consciously used by him. A clinical case is used to illustrate these two aspects of theoretical work. In the material presented, aspects of a first session are tentatively conceptualised. Then material from the same patient some years later is described, the method of working and the way of understanding is discussed and thus the process of conceptualising can be illustrated. The theme of hope has been singled out as a linking point between the earlier and later pieces of material.