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Historically, the role of interpretation in psychoanalytic treatment was consonant with a model of development in which the child needed to be enticed out of its autistic-narcissistic shell through the influence of reality as mediated by parents. The infant was believed to be unaware of its surroundings, protected by a stimulus barrier against impingements from the external world, and responsive only to inner urges of hunger, pain, aggressive discharges, and libidinal needs. Early development consisted of a laborious process of distinguishing between id and ego, inside and outside, fantasy and reality. For an adult patient to be able to utilize interpretations, considerable sophistication in having made these distinctions was necessary. Psychotic and narcissistic patients were unenticeable and hence unanalyzable. The analyst's interpretations had to strengthen the patient's relationship to reality and lessen the regressive pull of the id, with the observing ego functions remaining relatively intact.
The advent of empirical work on infancy, reformulations of the concept of transference, and the clinical-theoretical contributions of self psychology challenged the traditional model of development and its role in explaining the therapeutic action of psychoanalysis. Self psychologists have demonstrated that patients previously regarded as unanalyzable turn out to form analyzable selfobject transference. The analyst's interpretive activity is now understood to include a range of therapeutic endeavors. According to Wolf (this volume) it includes “all (the) intentional interventions by the analyst, verbal