Reconstruction and Perceptual Experience: Further Thoughts on Psychoanalytic Listening

Abstract

Freud's monumental shift to the fantasy theory heralded the view that "it is psychical and not material reality" which is our sole domain of inquiry. Yet despite theoretical agreement and cogent technical admonitions against concerning ourselves with absolute or "external" truths, psychoanalytic listening betrays a stance in which the analyst attunes to a reality other than that of the patient's inner world, assuming the position of arbiter--even if a silent one--of what is or is not "distorted" in the patient's perceptual experience. The central impact of perception as a significant component of the patient's inner experience--past and present--goes unattended. Clinical examples from differing theoretical persuasions are reviewed to demonstrate this occurrence. An alternative mode of listening is considered which assumes an underlying shift in outlook, suspending any notion that we can "know" what is "correct" in the patient's perception, while sharpening attunement to its clinical impact--as may be evidenced by a shift in affect or state, a turn of phrase, or the transient appearance of a symptom or old behavior. It is argued that such a stance will lead to a more singular focus on the patient's psychic reality, permitting the emergence of a deepening realm of psychic phenomena, enhancing the capacity of self-observation, and richly facilitating the reconstructive process.

Engagements in the analytic work

“…Here the aim, in Schwaber's (1986) words, is to suspend "any notion that we already 'know' " in order to "enter another's inner world" (p. 930). if at moments we can know ourselves only by what the patient tells us, an inquiry into the patient's world and our own may open to the essence of the work and place both analyst and patient equally at risk (Smith, 1990).…”

“…By "analyze them" I am referring to the analysis of the patient's transference and the analyst's own self-analysis. The examination of the patient's perceptions of the analyst's activity, which Schwaber (1986) and Gill (1982) from separate perspectives have advocated, would seem to be useful toward this end.…”

The influence of the analyst's narcissistic vulnerability on his work

“…By attaining a clearer vision of his own mental processes, by unsparing honesty with himself, we hope that our patient's distortions of perception of the outer world will be reduced to a minimum." It is assumed in this approach that there is one reality experienced by the patient and another "known" by the analyst to be objectively true (Schwaber, 1983c). As time went on I began to question this traditional approach.…”

“…Schwaber (1981aSchwaber ( , 1981bSchwaber ( , 1983aSchwaber ( , 1983bSchwaber ( , 1983cSchwaber ( , 1986Schwaber ( , 1987, gives multiple illustrations of this. The analyst may discover that he was following his own agenda.…”

The Role of Questions

“…The new wave of self psychology's interest in empathy or Schwaber's (1986) idea of keeping our concerns within the con fines of a patient's psychic reality have lead to criticism of analysts who ask too many questions, except for those that inquire about breaks in the empathie mode. The analyst then says, "What has led you to conclude that I have been insensitive?"…”