In the Eye of the Beholder—A Reply to Levenson

IN HIS RECENT PAPER, LEVENSON (1989) argues that analysts commonly do not take serious enough interest in what patients say explicitly about them or about outside matters. They are too busy ferreting out latent meanings at the expense of inquiring into and coming to grips with the realities of the patient's life experience. He feels that this is true not only of classical analysts with their preoccupation with drive-determined fantasy, but also, in a more subtle way, of self psychologists insofar as there is a disclaimed condescension in their attitude towards the patient's deficit-determined experience. Levenson claims that he shares Gill's and my own perspectivist viewpoint which he associates with "acceptance of the patient's reality" (p. 547). However, he also opens the paper with a long quotation from one of the transcribed and annotated psychoanalytic sessions in our book (Gill and Hoffman, 1982) which he uses to illustrate yet another way that interest in possible latent meanings—in this case taking the form of disguised allusions to the transference—detracts from attention to what patients tell us about their lives.

Levenson does not grapple with the implications of the apparent points of convergence and divergence in our views. We are apparently in agreement in taking the patient's perspective on the analyst's contribution to the process seriously. However, Gill and I look for oblique references to that contribution in the patient's communications about other matters whereas Levenson would prefer to focus on the manifest content, particularly when it is striking in its own right. In the quoted excerpt, the patient reports that at the end of one summer her mother left a pet cat in the furnace room of the family's summer home, one of several instances