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This study was prompted by the frequent use of the expression ‘know what I mean’ by a patient, J. The meaning of the expression changed over three years of weekly sessions. Initially it felt like an order to know and a demand that the patient brought to the treatment. Over time the command changed to a question offering more space between the patient and myself. As the space enlarged sufficiently for the patient to recognise myself as other, she prefixed the question ‘do you know what I mean?’. After three years the patient had stopped using the expression, and by then we were both perhaps able to accept that I did not always know what she meant, but that the therapy offered the opportunity to explore the meaning together.
The statement reflected the patient's lonely and misunderstood experiences as a child and adolescent, but the search for ‘knowing the meaning’ brought forward complex issues both about the work with the patient and about my acceptance of becoming and being a psychotherapist.
The definition of ‘knowing’ includes: recognition; having personal experience of, being aware of, and having, the technical expertise. The definition of ‘meaning’ includes: having in mind; intending to convey and signify. At its most superficial, ‘know what I mean’ is an almost meaningless reflex colloquialism. In the therapeutic setting the phrase has a superficial level - the therapist can be aware of what the patient is intending to convey. At a deeper level recognition of what the patient has in mind and is signifying is much harder. When commanded to understand, the therapist can only reflect back her/his recognition of the patient's need to be understood and, as the words shift, the therapist can work with the patient in the transference to reveal the deeper significance.
Knowing what is meant carries with it its counterpart, not knowing what is meant. In turn the conscious meaning also has its counterpart: the unconscious meaning, the meaning which is underneat