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Philosophers … seek the truth … to understand what could make the world appear the way it does. Philosophers do indeed want to see how things hang together. The problem is, however, that our conceptual scheme does not hang together, for it is riddled with inconsistency. To achieve a comprehensive and coherent view of the world, the philosopher tries to eliminate these inconsistencies by constructing conceptual schemes in which they do not arise.
The postmodern position in the human sciences has shifted our activities from attempting to emulate the natural sciences to a hermeneutics of suspicion (Ricoeur, 1970), in which we attempt to ferret out the implicit assumptions of a philosophical, methodological, and even political nature that ground or constitute our approach to what we call understanding a patient. Because all our interventions in psychotherapy and psychoanalysis are or ought to be based on this understanding, it is obvious that we must attempt to get as clear as possible about these implicit assumptions.
The many conflicting approaches to understanding the patient and the patient-therapist interaction in our field reveal an unfinished search for a consistent conceptual schema, and compel us to act on a contingent basis whether we know we are doing so or not. This does not allow us the luxury to follow Rorty's (1979, 1989a) suggestion that philosophers restrict themselves to skeptical ironist activity, a sort of “kibitzing,” with which neither philosophers who are concerned about the state of the world or physicians who are concerned about the state of their patients could ever be content. In this paper I will focus on a number of difficulties and assumptions implicit in various approaches to the human