A case is not a fact

Why do we publish clinical data? Between the scientistic illusion that assumes that cases are objective data and the disillusioned observation that psychoanalytic literature is mainly used to boost identity feelings, what role is played by such publications? New psychoanalytical knowledge results from clinical practice and not from scientific experiments or observations. A clinical vignette, even more than a full monograph, is clearly not designed to prove a theory from objective facts but to illustrate a particular clinical view. The quality of a case report relies on at least three criteria: data economy; adequacy to the proposed thesis; and convincingness or persuasion. A case is not a fact, because understanding it presupposes 'semantic holism': understanding any mental state requires taking into consideration a 'world of knowledge'. Empathy results from an unlimited work of inferences. In presenting a case, the psychoanalyst is always in a sense a 'thought-reader'. He describes what he believes he discovers.