Truth and Reality in Psychoanalytic Discourse

Dear Sir:

Thank you for this opportunity to respond to Dr Hamilton's letter.

On her further consideration of my work, Dr Hamilton notes that there appears to be an inconsistency in my position, that I mix a relativistic with an objectivistic terminology, which leads to a certain confusion in portraying my clinical stance. It is, however, my view that what may seem an inconsistency, speaks rather to a central paradox: the analyst's participation is intrinsic to the patient's experience, but our interest in that participation, and in our interaction, resides with how it is experienced—however hidden or defended—by the patient. There is a truth we seek to discover, not to construct—and it is that of the patient. That is our data base, our investigative terrain. It is surely difficult to tease apart 'theoretical perspective' from 'observed data', 'inference' from 'discovery', but this is precisely the process in which I believe we must stay engaged. Though we may not fully attain it, we must continuously strive towards it. To do so will require our sharpened attention to the nuances in the patient's stated and unstated communications, which in turn, can inform us of just how we may have clouded these distinctions, and indeed, have confused 'outward appearance'—as it looks to us—with 'inward experience'—as it feels to the patient. Sustaining this position will further necessitate a vigorous effort to keep clear the delineation between our vantage point and that of the patient, to recognize that our 'truth' is only that—our own, and to distinguish hypothesis from evidence. (See Schwaber, Book Review of Psychoanalytic Case Studies, edited by Sholevar & Glenn, in this Journal, 1993, pp. 409-413, in which I comment on the frequency with which these boundaries are blurred.)

Dr Hamilton writes as though implying that I am posing yet another model, namely, 'the listening stance'. That is not my intent. It is rather, to suggest some considerations about how we listen no