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Stewart, H. (1990). Interpretation and Other Agents for Psychic Change. Int. R. Psycho-Anal., 17:61-69.

(1990). International Review of Psycho-Analysis, 17:61-69

Interpretation and Other Agents for Psychic Change

Harold Stewart

I have broadened the theme of interpretation to include other types of intervention that are often necessary to effect psychic change in our patients when interpretations are not achieving their desired effect. My reason for doing this is that a great deal of analytic work and thinking has been done on precisely this issue by our leading Independent analysts, particularly Donald Winnicott and Michael Balint, which has helped to widen the range both of our therapeutic armamentarium and of the type of patient treated. This paper will be devoted to the clinical aspects of some of the issues involved.

The notion of the term 'environment' suggests three different facets to me. The first is the usual meaning of the term which includes the world in which the patient presently lives, his relationships with family and friends, his social and work settings. The second is the world of the patient's past from earliest infancy and childhood to the present day. The third facet, and the most important one for the treatment, is the patient's relationship with the analyst together with the setting in which the analysis is taking place. Over the course of his analysis the patient will be speaking of all three facets of his environment at different times, as well as speaking of his inner world, and the analyst is faced with the task of interpreting this material to the patient. These interpretations will be of two sorts, transference interpretations of the relationship of the patient and

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