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HOW DOES THE ANALYST GET to "know" the patient during the course of treatment? And what is the nature of this knowledge? While this question summons up the issue of epistemology, classically defined as the "theory or science that investigates the origins, nature, methods and limits of knowledge" (Webster, 1983), the relevance of epistemological issues strikes the practicing analyst as rather remote and austere. Epistemological themes generally center around rationality and theory. When one thinks of knowing the other (or self knowledge) in the analytic situation, a rather more personal and experiential order of events comes to mind, an intimate kind of knowledge that affects a lived life and eludes the neater, more cerebral categories of reason and logic. Truthfulness in this context would seem to have more to do with a sense or significance (Loch, 1977) rather than a veridical correspondence with the facts.
Perhaps another question might be: "How important is knowledge in the psychoanalytic situation in the first place?" There is the presumption that insight, self-knowledge and related notions are effective in bringing about change or cure. For surely psychoanalysis as a treatment or a praxis is first and foremost a therapy that has to be judged on some basis of efficacy. Psychoanalysis is so steeped in concepts integral to truth and self awareness, as in the exalted role of interpretation, and making unconscious conscious, that one can hardly separate this core epistemic function from psychoanalysis'