Discussion

PSYCHOANALYTIC INQUIRY was dominated for a long time by a search for contents. Initially, hidden nuggets were sought and that which concealed them was regarded as merely an annoying barrier to the success of the analyst's depth probing. Increasingly over the past few decades, the organization of the ego has been recognized as an at least equally, if not more important determinant of how the patient has come to be in whatever dilemma brings him to therapy. Dr. Ortof's paper is an interesting contribution in this direction. She presents her patient's dreams to us not primarily to perform the traditional task of unmasking secret fears and strivings, but rather as an illustration of the patient's growing ability to reflect upon and organize the events of her inner and outer life. Dr. Ortof is not asking us to neglect the traditional lessons which dreams may teach us. She is, however, pointing to the dreams and associations to the dream, as a source of insight about the quality and organization of experience as well as a guide to content. This is a point of view all too uncommon in discussion of dreams. It is a viewpoint especially well suited to the communication of the experiences of another human being, as Shapiro and Schachtel have vividly demonstrated.

A note of caution is in order, however, about the use of illustrative excerpts from a richly detailed therapy process. Recent research has documented what we have all known all along, but have preferred to keep in the background—the ease with which one can derive impressions of trends in clinical material, whether they be there or not. The excerpts which Dr. Ortof presents to us do appear to arrange themselves neatly into a pattern of increasing ability on the part of the patient to reflect productively upon the meaning of her dreams and to conceptualize the events of her life. Our confidence in this pattern of progress would be greater, however, if we could be assured that the selection of excerpts was in f