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Perhaps one way to enhance the effectiveness of dynamic psychotherapy or psychoanalysis is to particularize and enrich our patients' personal narratives (Ricoeur, 1984; Schafer, 1983, ; Spence, 1982; White and Epstein, 1990). Personal narrative, as used here, refers to a story a person might tell about him or herself if he or she had the capacities to articulate the story and, as important, someone willing to listen—to give the time and quality of attention such a story warrants (Horney, 1987). One aspect of this enrichment of personal narrative is the broader and more textured meaningfulness that words may come to possess through the process of analytic therapy. This theoretical point of view brings new emphasis to how utterance, discourse, narrative, and dialogue enable more vigorous and poetical engagement in the clinical encounter (Bakhtin, 1984; Bollas, 1992; Lacan, 1977).
More to the point is to consider the central place of how the indeterminacy of words in their function as signifiers matters in effective therapy. Although this proves elusive in the end, the exercise of this undertaking seems worthwhile. Somewhat later, I will enlarge on this postmodern/poststructuralist perspective on language, borrowing largely from Bakhtin, Lacan, Foucault, and Derrida as I have come to value their contributions. What I have harvested from these writers is, for me, grown largely in the soil originally cultivated by my study of the work of Karen Horney. The eminent Horney scholar Bernard Paris has referred to this kind of largely postmodern revision of Horney theory as neo-Horneyan, a characterization that I readily acknowledge may overly stretch the identification with Horney's ideas (B. Paris, 1996, personal communication).