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‘Patients who are not ready for interpretations’. A friend criticized this title on the ground that it implies some unreadiness on the part of the patient, not to be ready for something. As though patients ought to be available for interpretations, as though interpretation is what psychotherapy is about. This is not what I believe. Psychotherapy is therapy: it is about enabling people to explore their processes, conscious and unconscious, so that they can understand better what they are doing in their lives and gain some control over the alternatives which are in principle available to them. We know that it can be helpful, in pursuit of this goal, to interpret to people the unconscious meaning of what they are doing or feeling or thinking. But we also know of people we are not able to help by this means, and therefore a more accurate if clumsier title would have been ‘Patients for whom interpretations are inappropriate’. Or, even more accurately, ‘Patients for whom interpretation of unconscious material is inappropriate’. What I find inappropriate with particular people is for me to bring in aspects of their experience of which they are unconscious, which are ego-alien to them and sound strange to them.
My first example is of someone who could not tolerate what she experienced as my intrusiveness.
I saw ‘Rose’ for more than 10 years, from her early twenties onwards. She came twice a week to me individually and once a week to a group I run. She was dreadfully depressed, anxious, and generally unalive, living most of the time in what she described as a grey fog. In the first couple of years I interpreted in the normal way what I thought was happening to her or between us. She seemed to listen to what I said, often agreeing, and we got nowhere much except that she did keep coming. I cannot take much credit for this, for early in her third year she was able to tell me that she had not exactly come for therapy: she had been sent by an unfortunate alliance of her boyfriend