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This paper examines epistemological plurality in contemporary relational psychoanalysis. I draw on clinical material with my own clients who have experienced environmental trauma in early life, such as experiences of incest, battery, abuse and molestation. In this paper, I put forward arguments for the positivist thinking within the development of psychoanalysis, as well as drawing on neuroepistemology, postmodernism and hermeneutic philosophy to consider the ways in which epistemological plurality may provide a more holistic way of conceptualising clients concerns. In this paper, I highlight the role that language, and the analysis of language, plays in meaning making within psychotherapy.