Therapeutic action, epistemology, and the ethic of psychoanalysis

It is contended that changes in the theory of psychoanalytic technique resulting in the recognition that interpretation is insufficient and the analytic relationship plays a significant mutative role have far-reaching implications that have yet to be sufficiently appreciated. The theoretical changes undergone by two prominent analysts, Heinz Kohut and Herbert Rosenfeld, are used to illustrate the importance of shifting the relationship between theory and practice so that the patient's experience is given primacy. Although theoretically psychoanalytic technique has given importance to listening closely to the patient's material, in fact this technical principle has always conflicted with the assumption of presumed analytic knowledge of the patient's psychopathology. The emerging technical stance undercuts the objectivist epistemological position that has long dominated psychoanalysis in favor of a hermeneutic model of psychoanalytic understanding. While it is recognized that theory is essential to the analytic process, the thesis is that psychoanalytic praxis must be informed by the patient's experience and therefore requires a psychoanalytic ethic of not knowing, thus reversing the objectivist epistemological stance. Copyright © 2005 John Wiley & Sons, Ltd.