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The conviction that the psychotherapeutic process is effective depends on the development of the therapeutic attitude and identity. The therapeutic attitude, in turn, depends on the orientation which can be developed regarding the gathering and understanding of psychotherapeutic data. The first difficulty encountered
is the switch required from the usual patterns of observing and attending, a switch away from the 'ground rules' of social communication in which it seems that all communication is taken at face value and is under conscious control. There must be an awareness of the existence of preconscious and subliminal impressions or stimuli in the treatment situation and of the longitudinal and genetic determinants for manifest observables, as well as for connecting links between them. In regard to understanding, the 'ground rules' include two basic assumptions: understanding is conscious and it is immediate. In contrast to this, the therapeutic orientation is one in which understanding cannot be immediate or conscious.
Without conviction about these orientations regarding therapeutic gathering and understanding of data the beginning psychotherapist may display limitation of perceptions with a tendency to deal with the patient's communications at face value, or he may ignore most manifest observables and think on deeper levels than therapeutically indicated, or he may be inactive. Didactic instruction, case supervision, and self-scrutiny contribute to intellectual acceptance or acceptance on faith. The problem is to convert this acceptance into objective therapeutic conviction.