The conceptualisation and communication of clinical facts in psychoanalysis: a discussion

The author states that the 75th Anniversary Edition of the IJPA (December, 1994) offers a superb collection of diverse views on the daunting question of the ways in which we conceptualise and communicate psychoanalytic clinical facts. The focus of this discussion is certain methodological and epistemological concerns deriving from some of the ideas and clinical examples presented in these writings. It is noted that while our central task is to uncover and recover what had been outside awareness, the concept of 'The Unconscious' has inclined us towards inferring knowledge about another as though it were fact. There is a tendency, descriptively and clinically, to view the analyst as potentially capable, however he or she may arrive at this, of apprehending meaning that is yet unconscious to the patient. Turns of language take place that impute unconscious intentionality to the patient (e.g. 'the patient is unconsciously attacking the analyst') while relieving the analyst of responsibility in the evocation of the patient's perception (e.g. 'the analyst is unconsciously forced to play a role'). Thus, unexamined assumptions are introduced, while perception itself is relegated to a secondary, rather than primary experiential phenomenon, nuances of which remain outside analytic enquiry. As verbal and non-verbal data are often omitted from active exploration, the power of intellectual persuasion risks overtaking the requisite demand for evidence. Clinical examples drawn from each of the three geographical regions are reviewed in detail in order to explicate these conceptual dilemmas.