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This article analyzes and discusses the concept of consensus between patient and therapist in psychoanalytic psychotherapy. This topic has emerged in both psychotherapy research and analytic theory as an important construct and possible curative factor in psychotherapy. These independent lines of investigation will be reviewed and synthesized by considering consensus as a broader construct than simple agreement. Consensus is a creation of the dyad, based on an explicit and mutual effort to define the unique elements of the conscious and unconscious perspectives of patient and therapist. A theoretical understanding of the curative mechanisms of this process is proposed.
Consensus has been discussed extensively and independently in both the the-oretical and research literature on psychotherapy, although often not in direct terms. The term consensus is usually defined as a level of agreement between two people. There is, however, a qualitative aspect of consensus that could be described as mutuality of focus and shared reality. Sullivan (1950) described this aspect of consensus in his explanation of the process of consensual validation: “One' experience in using words has been observed with such care that one has finally learned how to create in the hearer' mind some-thing remotely resembling what one hoped he would think of” (p. 325).
Consensus is not simply agreement, but a creation of the dyad, based on an explicit and mutual defining of the unique elements of the individual perspectives within the dyad. It is the dyadic, or relational, form of consciousness. Recent theoretical and research developments that stress this point are reviewed in this article, and a theoretical understanding of the curative mechanism of this process is proposed. By working toward a mutual reality in the