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This extraordinary book, derived in large part from a close reading of the work of Bion, addresses some of the most vexing and important epistemo-logical questions at the heart of our clinical praxis: What is the nature of psychoanalytic knowledge? What do we know? How do we understand what we know? How is that knowledge acquired? And how do these questions relate to the action of psychoanalysis - to both the conduct and activity of two people conversing in a room and the therapeutic action that may follow from their discourse?
Caper begins his exploration of these topics by seeking to distinguish a specific psychoanalytic knowledge from the factual, reproducible knowledge of the physical sciences. While the latter investigates ‘material objects’, which can be known through the senses, psychoanalysis explores ‘immaterial objects’ “states of mind, beauty, grace, ugliness, good and evil, values” (p. 2), etc. -which can be known only through our sensibilities. In Caper's view, psychoanalytic knowledge is intangible, rooted in the ineffable, derived from observations, conjectures and hypotheses that await formulation, confirmation and emendation, and gives rise not to certainties, but to beliefs, opinions and further hypotheses. This stands in contrast to the discoveries of the physical sciences - or at least their medical subset - which more often deal with fixed, hard facts. Discovering the latter, Caper argues, eliminates the unknown and ‘vanquishes’ uncertainty, while analytic knowledge is always uncertain and continually expands the boundaries of the very domain it seeks to explore.
Since the phenomena with which psychoanalysis is concerned are states of mind, they cannot be replicated or controlled. Consequently, the data upon which psychoanalysis depends cannot be subjected to reproducible conditions or controlled experiments in the way physical illnesses such as diabetes or treatments such as insulin injections might be. This assertion may discomfort colleagues wh