Ambiguity in the Psychoanalytic Practice

One of the characteristics of practicing psychoanalysis is the high level of contradiction the practitioner has to deal with in his or her work. Often, we find ourselves offering an interpretation that seems to contradict everything we have said before, essentially because we are within a completely different context. Contradiction is in the essence of psychoanalysis. There are contradictions in our patients and also in us, in our practice. We often make interpretations, but we are not always right; our interpretations are hypotheses to be tested, and they always require the confirmation of our patient. Although patients often disagree with or dismiss interpretations, some sort of evidence will sooner or later confirm a correct interpretation.

At a recent session, the patient was going on and on talking about her hostility and anger toward other people. She was realizing that what she had considered virtues in the past, her outspokenness, her directness, her independence and frankness, when looked at in a new light, were signs of her righteousness and her indiscriminate belligerence. She was presenting, more to herself than to me, evidence of her hurting and isolating others. The patient, for the first time, took a serious look at her arrogance and vindictiveness. She felt quite bad and she recriminated herself harshly. A little later, she talked about a friend that she had always forgiven. He had forgotten to send her a card for her birthday. She called and he told her he had simply forgotten; she did not get mad; she did not feel anger toward him. She then said: How come I cannot be like that with everybody? She then turned to talk about the fact that she should be fair and even and pleasant and accepting with everyone. That was really what she always wanted to do. 1 pointed out to her that she wanted to be a saint. Her reaction was: Didn't we just conclude that I am the devil? For a moment she complained of being confused; she could not at the same time be the dev