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In contrast to classical psychoanalytic theory, Weiss (1986, 1990) has proposed that a person works, from infancy onward, to understand his reality and to adapt to it. In doing so, the person constructs, by inference from experience, a system of conscious and unconscious beliefs about his or her reality. These beliefs organize personality; some of them are pathogenic in that they lead to the development and maintenance of psychopathology. The patient works in therapy to change pathogenic beliefs and may use experiences with the therapist to disconfirm them and make progress.
My topic is the place of reality and a person's beliefs about his or her reality in psychopathology and treatment. The ideas I shall present are based on the distinctive psychoanalytic theory developed by Weiss (1986). I shall take up three interrelated topics. The first is the nature of a person's interest in reality. I will argue that that interest is innate, primary, and powerful. This fact is important not only for our theories, but also for our understanding and treatment of our patients. The second topic is psychopathology. I will develop the view that our beliefs about our reality play a central role in all aspects of our mental life, including the development and maintenance of psychopathology. My third topic is therapy. I shall discuss the importance of actual experiences between patient and therapist for the patient's