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SINCE THE FIRST, RUDIMENTARY, psychoanalytic treatment, Breuer's attempt at achieving a "talking cure" with Anna O., the relationship between analyst and analysand has been at the center of clinical and theoretical interest. The relationship is central clinically because technical interventions—what the analyst actually
does or thinks he does—depend upon how he construes it. Theoretically, because the clinical setting generates the bulk of our data, our ways of understanding the relationship between patient and analyst cannot be overemphasized, since they define the position of the observer in the observational field.
The postulate that "objective" data can be extrapolated from the psychoanalytic setting raises questions that concerned Sullivan throughout his career and that have been addressed provocatively in Spence's (1982) work on narrative and historical truth. Freud's concern with the issue is implicit, but it is an important aspect of many of his most famous statements about the analytic relationship. The blank screen, the reflecting mirror, the attitude of surgical detachment, etc., when read in context turn out to be responses to the anti-psychoanalytic criticism that suggestion by the analyst is responsible not only for therapeutic change but also for the data on which analytic theory and practice is based.
Freud's concern was justified. Spence, who seems to have rediscovered the principle of participant observation, argues convincingly that the analyst's creative contribution to the analytic process raises doubts about how easily clinical data can be generalized. While it is not terribly difficult to develop a theory of cure around this sort of interactive model of the psychoanalytic situation, it is much more difficult to claim universality for its dynamic an