This paper is an attempt to raise questions about certain underlying and implicit assumptions in some hermeneutic and narrative approaches to psychoanalysis. Starting from the view that Freud saw interpretation in the clinical setting as an attempt to unveil the analysand's psychic reality, it is argued that he envisaged that psychoanalysis aims to interpret what is real in the analysand's inner world—an empirical line of thought underpinned by the idea of analytic neutrality and an emphasis on the analysand's capacity to judge reality. By contrast, the tendency within the hermeneutic-narrative tradition is to demote psychic reality in favour of an emphasis on the analyst's capacity to interpret in order to help his analysand construct meaning. This approach may be said to put the analyst's words in the place of those of the Creator; in other words, it amounts to a 'verbal creationism', which the author argues is rooted in the idealistic philosophy of Hegel, Vico and Descartes and, further back, can be traced to the Book of Genesis—a conclusion causing the author to express some reservations.