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Communicative psychotherapy or psychoanalysis (Smith uses the terms interchangeably) is an attempt to restore the patient's voice which, argues Smith, all too often gets swallowed up in the discourse of the therapist. It claims to see things from the patient's point of view. This is not a new endeavour within psychoanalysis as is seen, for example, in a quotation from Margaret Little, which Smith justifiably describes as ‘one of the most memorable passages in the psychoanalytic literature on technique’ (p. 92):
We often hear of the mirror which the analyst holds up to the patient, but the patient holds one up to the analyst too, and there is a whole series of reflections in each, repetitive in kind and subject to continual modification.
Communicative psychotherapy, a type of therapy developed by Robert Langs, takes as its primary aim and purpose the uncovering, investigation and clarification, to both patient and therapist, of this mirror held up by the patient and within which the therapist can see a reflection of him/herself and his/her conduct of the therapy.
This mirror needs uncovering because it is nearly always kept under wraps. It shows itself indirectly and allusively, not in the explicit and conscious commentary which the patient makes on the therapist, but in other forms, notably in communications about other people. In the stories the patient tells about his or her life and the people in it, particularly those which have qualities of spontaneity and immediacy, the communicative therapist discovers hidden and unconscious communications about the patient's experience of the therapy. The patient's conversation is heard as a form of ongoing feedback to the therapist on the quality of his or her therapeutic skills and, indeed, his or her very suitability to be a therapist in the first place.
Such an approach entails a radical revision, a ‘revolution’ as Smith calls it, in the way we think in therapy of the connections between past and present. In what Smith calls