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When Kohut (1971) discovered that the resolution of selfobject transferences other than oedipal ones permitted patients to mature who had heretofore seemed unanalyzable, he expanded the therapeutic horizons of psychoanalysis as well as of psychotherapy generally.
Kohut said that we work by explaining to the patient what it is we have first understood. The emphasis on empathically understanding what a patient is saying or trying to say was a necessary corrective to the doctrinaire approach of those analysts who essentially advocated, even if they did not practice, the idea that the analyst was an objective observer, as opposed to a participant, removed from his feelings and reactions to the patient. However, we are in danger of forgetting that being understood is not the same as understanding, and in itself is not sufficient to bring about an analytic result. Analysis requires a judicious balance between empathy and interpretation, between understanding and conveying our understanding to the patient.
Interpretation is defined as explaining or giving a meaning. When the patient is explaining himself to us and/or to himself without impediment, there is no need for us to speak. We interpret when we believe that we have come to understand something about the patient that he or she cannot fathom or organize without our help. Something is in the way and we have to remove the obstacle, technically called a defense, and we hope to accomplish that with our explanation.
Just as we try to listen empathically—to hear what the patient is saying from the patient's point of view—so our interpretations must address the patient where we find him: that is, we must address ourselves in a meaningful way to the particular defensive operation that was cognitively possible for the patient at the time that the original trauma or traumas to the development of the self occurred that seem to be reflected in his present difficulties in the analysis.1 In other words, we must address the patient in