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Erik Erikson raises the question that Freud intended with his candid admission about Dora: “I do not know what kind of help she wanted from me.” Erikson's contention is that what Dora really wanted was more than an awareness of phenomenal and genetic reality. Going on assumption we are struck by the similarity of her demands to those of any child toward the parent, the significant person, the educator, the mentor.
From a philosophical point of view there are no objective criteria of reality. Our work remains, however, based on the search for reality, for the deeper reality, hidden behind distortions. This is its permanent challenge, its nobility and its tragedy. For the possibilities of error are infinite. Even in our practical work what is and what is not real may very well remain a controversial issue between analyst and analysand, with the analyst hopefully closer to reality. But this doesn't always have to be so. Often enough we find that the patient expresses a reality, or at least acts it out, which at the time we do not comprehend at all.
From a psychoanalytic point of view it may be helpful to think of levels of reality. What by conscious joint validation may be considered real may not be so on a deeper level. It is the imperative of our work that we proceed to the deepest possible level of reality. This is what Freud did. True, there have been later attempts to penetrate into deeper layers than he endeavored. But they lack somehow the