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Spezzano, C. (2001). How is the Analyst Supposed to Know? Gathering Evidence for Interpretations. Contemp. Psychoanal., 37(4):551-570.

(2001). Contemporary Psychoanalysis, 37(4):551-570

How is the Analyst Supposed to Know? Gathering Evidence for Interpretations

Charles Spezzano, Ph.D.

In a Book titled Invisible Cities, Italo Calvino (1974) suggested that we are attracted to our favorite cities not simply because they delight us, but because of the answers that these cities give to questions we bring to them. Patients come to analysis seeking relief from their anxieties, pains, and disappointments, but their quest comes to involve somebody understanding something, and so, questions emerge. Three categories of these questions often are directed, even if only implicitly, to analysts by patients in hope that the answers will be clues to transformational or maturational amelioration of emotional sufferings and life disappointments: When you listen to me, do you notice anything that I don't? What do you find emerging into consciousness in your mind during our time together? Is there anything special about the way in which we, in particular, end up doing whatever it is that is done in this room?

These questions link to the “how” in the title of this essay. What the analyst is supposed to know—or come to know—is something about the immediate unconscious mental activity and the enduring unconscious psychology of the patient. How the analyst comes to know this is by gathering evidence at three sites in psychological space: the patient's associations, the analyst's reverie, and the transference-countertransference dramas jointly created by the patient and analyst. The discovery of these three sites forms a core part of the history of psychoanalysis.

Why the Patient Speaks to the Analyst

People talk to clinicians because of disturbing affective experiences. Regulation of affective states has emerged, especially during the last decade, as a core concern in theorizing and interpreting by analysts of various persuasions.

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