What Does the Presentation of Case Material Tell Us about What Actually Happened in an Analysis and How Does It Do This?

The above title suggested for this discussion (Blass, 2013, p. 1129) alludes to topics of such magnitude and complexity that in the present context I will primarily consider only one of these that has been perhaps most neglected - the process of contextualization that clinical presentations should make apparent, but often fail to. Theoretic pluralism has not eliminated ‘the’ unconscious as a theoretic bedrock source for the suffering of our patients. We have always shared the assumption that this suffering seeps into meaning-altered derivatives, which can only be accessed via an assumption that the links between manifest and latent meaning are disguised. But there is an abiding confusion about our methodology of inferring latent meaning from manifest content. Here, a paradoxical gap between theory and practice is nowhere more apparent or consequential. Our various alternative theoretic models provide diverse explanations for the causes of the transformation of unconscious affective pressures into their manifest derivative. But, without exception, these different theoretical models are, to varying degrees, silent or vague about the best methods of translating latent content to manifest content, and they always have been. Just as we have always known that there can be no meaning without context we have just as often ignored the task of stating why we have claimed that certain data warranted contextual significance. If we pin everything on context, why have we given so little attention to the methodology of contextualization?

To contextualize is to privilege and justify certain information. I use the word ‘justify’ here not in the connotation of legitimizing, let alone ‘validating’, but in the sense only of epistemic justification.1 It should be incumbent on our authors to show why they have decided to grant contextualizing importance to certain information. This is not at all the same as proving that this wi