8 Discussion: What Makes for Effective Analysis?

The contribution to psychoanalysis of the authors of the two previous chapters can be broadly summarized by the question “What makes for effective analysis?” Both Wallerstein and Wolf implicitly address that question from different vantage points. I will demonstrate this by briefly summarizing and then discussing them.

The main point Dr. Wolf makes in his clinically oriented chapter is as follows: Progress in psychoanalytic treatment is achieved through the reconciliation of the discrepant realities of the patient and the analyst as these develop in the interactions of the analytic situation. These discrepant realities arise from the particular psychological experiences of the two participants. Relevant to this is the notion of ostensive knowledge—that is, knowledge or insight obtained through firsthand emotional experience. Opposed to it is descriptive knowledge or insight that derives from secondary (intellectual) sources. The latter is more experience-distant cognition; the former is experience-near, gut knowledge. The two points, discrepant reality and ostensive insight, are connected by way of the question of what leads to an optimally effective working through process in treatment. The indepth, empathic ostensive grasp of each other's (analyst and patient) conveyed realities optimally leads to the understanding and eventual resolution of the patient's core disturbances. Wolf emphasizes two points: (1) that the discrepancies are recognized, made public, as it were, and accepted; and (2) that as they are dealt with a mutually agreed upon psychoanalytic reality evolves that leads to working through and eventually to termination.

In contrast to Wolf's clinical—technical interest, Dr. Wallerstein takes up large-scale theoretical issues that, while they have important