Introduction: How Does Talking Cure?

It is both strange and true that contemporary psychoanalysis lacks a fullexplanation for the therapeutic action of talking. To be sure, we have attributed to language various mutative effects of psychoanalytic treatment (e.g., insight, structural change, expanded mental capacity), but we have not elaborated the specific verbal mechanisms responsible for these effects. To take the most obvious example, we do not have a satisfactory explanation for how the special cognitive-emotional realization known as insight facilitates new ways of living or being. Our primary explanations (e.g., making the unconscious conscious; where id was, there ego shall be) are fundamentally tautological: insight leads to change because self-knowledge sets one free (see Eagle 2011). Given our expanding appreciation for the many forms knowledge can take, such explanations do not tell us why verbalization or even consciousness is necessary.

For those who believe in the power of words, the therapeutic action of language is self-evident. For those who do not, the explanations leave out too much. For instance, many theorists of verbal therapeutic mechanisms do not fully account for various types of relational experience that undoubtedly contribute to therapeutic action; Loewald (1978) and Litowitz (2011) are notable exceptions. Moreover, theorists advocating mechanisms that operate via relational experiences rather than words—and yield change that may or may not be verbally articulated or consciously known—are filling the vacuum of explanation regarding therapeutic action. Importantly, explanations of “nonverbal” mechanisms (e.g., Boston Change Process Study Group 2008) are often well-developed and integrated with findings of systematic research, thereby appealing to wishes for currency and cogency. By comparison, explanations of verbal treatment mechanisms may appear insufficient and outdated, the