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Richard Moore's The Creation of Reality in Psychoanalysis is a bold, important, and extremely well-written journey into waters, as he shows us, that have never been thoroughly and consistently charted, the waters of unapologetically and wholeheartedly constructivist psychoanalytic thinking. Other explorers—Donald Spence, Roy Schafer, Robert Stolorow, and Irwin Z. Hoffman—have ventured into these places, but all have returned, in one way or another, to the safe haven of positivism (understood by Moore as any kind of belief in any kind of extra-subjective reality). Each appeared to be the needed psychoanalytic hero, and each has made a significant contribution to post-Freudian psychoanalysis, but each in turn has failed the ultimate test of courage and has become at least a partial disappointment.
Donald Spence (1982), recognizing that the search for literal, historical, verifiable truth in psychoanalytic work was futile and a clinical dead-end, conceptualizes the psychoanalytic project as the building up of narrative truth about a person's life. Implicitly relying, as do all four thinkers, on the principle that observation itself changes what is observed, Spence has encouraged us to be content with not knowing what actually happened, and to accept pragmatically a narrative truth built up in the very telling of the story. In Moore's view, by questioning the presumptively tight connection between truth and cure in psychoanalysis, “Spence seems to have dropped a kind of depth charge into psychoanalysis from which neither he nor psychoanalysis has been able to recover” (p. 59). Unfortunately, from Moore's perspective, Spence never discarded the idea of external reality. Spence claims merely that the psychoanalytic process provides no reliable access to such objective, historical truth. What we seek, in Spence's dual-truth view, is the best possible approximation, but for Moore this means, unacceptably, that Spence believes in an underlying reality or truth that we attempt