Case Reports in a Two-Person World

Traditional anecdotal case reports are usually written as a 1 st-person narrative, a tale told from the point of view of the treating analyst. Quotations from the patient are sometimes included, but readers rarely have access to the thoughts of either analyst or patient. Perhaps it is because of these omissions that the literature of case reports and transcribed recordings has uncovered only a few examples of persuasive interventions and has not contributed much to the understanding of what exactly brings about change in the course of psychoanalytic treatment. Perhaps the meanings readers seek are not in the published narrative but in the patient's and analyst's contexts of understanding—and these are left largely unrecorded. If ways were found to capture this context, analysts might better understand the principal ingredients of significant clinical happenings.

Postmodern approaches to the world (see Kirshner, 1999; Slife, 1999) are coming gradually to agree that the search for timeless and immutable laws in the study of the mind may be a fruitless project. Slife wrote that

in traditional science, the ultimate foundation for reality is considered to be natural laws…. The truth of these propositions does not exist in any special

Donald P. Spence, PhD, Department of Psychiatry, Robert wood Johnson Medical School, University of Medicine and Dentistry of New Jersey.

Correspondence concerning this article should be addressed to Donald P. Spence, PhD, 9 Haslet Avenue, Princeton, New Jersey 08540. Electronic mail may be sent to .

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location or era…. This is the reason that science attempts to: eliminate contextuality through laboratories and rigorous procedures. (Slife, 1999, pp. 2, 3, 6)

The postmodern position, by contrast, is inclined to believe that our observations are always rooted in a particular intersection of time and space; accordingly, there may be no such thing as “objectivism (e.g., scientism), value-free languages (e.g., positivism), metaphysica