Rejoinder

Fred Busch's concern in this paper is with consciousness and various aspects of it, which he feels have not been given sufficient attention by psychoanalysts. He describes his position in the following way: ‘Whenever we interpret something unknown to a patient we express our belief it is knowable’ and he adds that it is his impression that ‘we haven't spent enough time considering the reasons for this, leading to interpretive methods with little consideration for surfaces in the mind’. He goes on to mention a number of aspects such as the need to help the patient to develop the capacity to deal with anxiety, the importance of taking very seriously how for the patient ‘thoughts and feelings are not so much expressions of psychic reality; they just are’. But I would add that surely trying to help our patients to use their minds to think about what is going on rather than just taking them as they are is basic to all our work as psychoanalysts?

Busch stresses the importance of the technique helping the patient to reflect upon his thinking as opposed to just living out his phantasies. I again question whether this is not basic to all psychoanalytic technique. He thinks that ‘the most frightening aspect of psychoanalytic treatment is for the patient to consciously know, or sense he is becoming aware of: the specifics of unconscious fantasies and how these are gratified’. A further point that I consider a very major ‘frightening