Aspects of Reality, and the Focus of Interpretation

In this paper I discuss some of the difficulties associated with the notion of a dichotomy between physical and psychic reality, and the way in which the analyst's judgment concerning the nature of either influences his choice of interpretation. After briefly offering an alternative approach based on the concept of different versions of the history of physical reality and of psychic reality, I present clinical material to illustrate how the analyst may make use of information of different kinds — derived from his knowledge of the patient's history, his observations in the session of her tone and manner of speaking, as well as the contents of her material, and particularly his experience of the atmosphere and nature of the relationship that is being lived out between himself and the patient. Rather than trying to determine the nature of the patient's psychic reality as distinct from the material reality, the analyst can recognize, as the session unfolds, different versions of reality and can begin to build up a picture of that version which is most clearly manifested in the consulting room at the time, and which is probably the most useful focus for our understanding and our interpretive efforts.

Freud's delineation of the concept of psychic reality represented an important conceptual advance: “It remains a fact that the patient has created these phantasies for himself, and this fact is of scarcely less importance for his neurosis than if he had really