Inference And Evidence In The Clinical Situation: The Analyst's Use Of The Self

George Klumpner opened the panel with an orientation to its methods and goals. The panelists had been asked to illustrate how each thought about an experience with a patient is a means to address a variety of issues concerning the analyst's use of the self in accumulating evidence and making inferences. How do analysts define inference and evidence? What do analysts count as the data that form their theories? How do analysts test their inferences? What are the criteria for judging the correctness of an inference? What protections are there against personal bias? How do analysts use their inferences, and what is the effect of various uses on the analytic process? To stress the importance of these questions, Klumpner recalled Ishak Ramzy, who twenty years ago pointedly noted that analysts jump to conclusions while rarely delineating the evidence and reasoning that have led to their understanding. The result is a vulnerability to accusations of circular thinking and of imposing one's biases on patients' emotional lives.

Klumpner, noting the problematic fact that inference and evidence have no single definition, suggested that useful definitions might be arrived at by attending to the two sources of information about our patients. He proposed that we define evidence as information coming from the patient and inference as information coming from the analyst. Processing both types of data results in the analyst's increased understanding of the patient, though a balanced application of the two is of great importance. A particular danger lies in the overemphasis of the analyst's free-floating ideas, which can derail the analytic process through the misattribution of imagination as fact or through a failure to