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How one thinks about the nature of what analysts know about themselves and their patients is said to have practical implications for the way analysts work. A social-constructivist view of the process is contrasted with both the objectivist perspective and what is termed the “limited constructivist” view. The latter, exemplified by Schafter, focuses only on the way theory affects interpretation. At the heart of the more thoroughgoing social-constructivist viewpoint is the notion that analysts cannot know the full meaning of their own behavior, both retrospectively (in the context of interpretation) and prospectively (in the context of deciding what to do from moment to moment). The model requires that analysts embrace the uncertainty that derives from knowing that their subjectivity can never be fully transcended. Nevertheless, this very uncertainty frees analysts to “be themselves” within the constraints of the purposes of the analysis. Analysts can now “speak their minds,” including expressing conviction about their points of view, even sometimes when they clash with those of their patients. Both uncertainty and conviction are present but have different meanings in constructivism than they do in “open-minded positivism.” In the constructivist view, what had been known before on the basis of theory, research, or cumulative clinical experience is not discarded; rather, the authority of that knowledge is subtly diminished in proportion to a subtle increase in respect for the analyst's personal,
Dr. Hoffman is Associate Professor of Clinical Psychiatry and Behavioral Sciences at Northwestern University Medical School, Lecturer in Psychiatry at the University of Illinois Medical School, and Supervising Analyst at the Chicago Center for Psychoanalysis.
© 1992 The Analytic Press
subjective experience as a basis for what the analyst does or says. Several examples are given of the way this attitude can affect practice.