PubMed1998
Beginning with Nietzsche's doctrine of "perspectivism," there has been an increasing realization in the sciences that the notion of an objective detached observer who reaches truth as he or she studies the subject is incorrect. There is general agreement that the subject-object dichotomy in 19th-century science that lies behind traditional sciences and was assumed by Freud is incorrect. As a result we now have in psychoanalysis a movement at the other extreme called "constructivism," which assumes that on a moment-to-moment basis the analyst and patient together creatively construct the data, interpretations, and "truths" that result. This incidentally casts Kohut's method of empathic understanding as the way to accumulate data in the psychoanalytic process under suspicion, because it is questionable whether the analyst is able to empathize with what is allegedly already there in the patient; it could not be correct if the analyst and patient are constructing what is "already there" together from moment to moment. The same would be problematic about the analyst's allegedly empathic grasp of the patient's "sense of self," which lies at the center of self psychological investigation. What we have come to realize is that every psychoanalyst approaches patients with a tool kit whether it is displayed or not. Levi-Straus pointed out that the tool kit is for the use of a bricoleur, a potter. The more tools in the analyst's kit, the more sense the patient will make to the analyst, a good argument for the five-channel theory of psychoanalytic listening I (Chessick, 1992a) have previously presented. This is not consistent with the traditional theory, which emphasized insight into the developmental origins of psychopathology through analysis of the transference as the central mechanism of therapy. Now, it is argued by some, the treatment process itself, the sample interpersonal interaction and interpretation of the current relationship between the analyst and the patient as created by both of them is crucial to catalyzing a change in the patient. Is this a form of after-education and a travesty of traditional psychoanalytic thinking, as some authors claim, or is it a more sophisticated stance that deepens our understanding of the psychoanalytic process and especially of the analyst's contribution to it? Extrapolation of this question can also lead us to investigate how each country creates a form or theory of psychoanalysis that it needs, in an effort to understand why there is so little agreement within the international body of psychoanalysts. Emphasis on the creative input of the psychoanalyst, which tends to be downplayed in the traditional literature, is becoming increasingly realized as important as we go into the 21st century.