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T. S. Eliot (1930) in the voice of apeneck Sweeney notes, “I've gotta use words when I talk to you!” That brief sentence, uttered in frustration, could as well be applied to the patient and analyst when they are in interaction. There are, of course, other aspects of the discourse of psychoanalysis, but at its heart it is word-centred, leading to understanding and change. Psychoanalysts do not subscribe to epiphanies or sticking pins into fetishes as vehicles of change. They talk about their patients’ lives, ideas, feelings, and attitudes, and try to arrive at a coherent image of their past as remembered in words. They then assess its relevance to their current behaviour and how that relates to their misery and suffering as well as the cruelty that they do to others.
The centrality of words in Freud's model of understanding and treatment and his zeal for understanding the formerly mystical by translation of mental images and dreams into words has always fascinated me. Indeed, the very unconscious fantasies that he discovered as the underpinning of behaviour must yield to narratives about conflict that are voiced in words. Other therapies may embrace hugging, beatific smiles, or ritualized mantras, but none other tries to make behaviour understandable from the vantage of words as they relate to the unconscious fantasies that are displayed in the transference, in life, and in symptoms. These very words become handy tools to be brought into action whenever we meet an old enemy from within that can now be named and with that name can be mastered. Thus from exposition to interpretation it is words all the way (Shapiro, 1970).