Jacob Arlow - Empathy, Introspection, and Intuition in Interpretation

"First, the analyst had made an identification with the patient, but, with the intrusion of the "extraneous" thought into his mind, he has ceased being the passive recipient of the patient's productions and has taken on the role of observer interpreter. Second, and perhaps most important, is that the analyst's free association, even when it seems random and remote from the theme of the patient's thoughts, represents his inner commentary and beginning perception of the patient's unconscious thought processes. An exception to this is, of course, the situation of extreme countertransference reaction. Third, the analyst's free association represents a form of inner communication to himself, a first step in the awareness of the insight which he is about to apprehend. Fourth, what the analyst has perceived through introspection is the end result of a process of intuition. Intuition consists of being able to organize silently, effortlessly, and outsde of the scope of consciousness the myriad of observations, impressions, facts, experiences, in a word, all that we have learned from the patient into a meaningful pattern without any sense of the intermediate steps involved. When we examine closely the full range of communication between analyst and analysand, such phenomena no longer suggest anything supernatural. The patient uses several modes of communication with the therapist. He expresses himself verbally and nonverbally. Mode of behavior, facial expressions, body posture, different gestures, all transmit meaning which augments, elaborates, or sometimes even contradicts what the patient articulates verbally. The timbre of the voice, the rate of speech, the metaphoric expressions, and the configuration of the material transmit meaning beyond that contained in verbal speech alone. All of these are perceived sometimes subliminally and are elaborated and conceptualized unconsciously, i.e., intuitively. There is something intensely aesthetic and cretive about this mode of functioning. Scientific discoveries and artistic innovations of enormous complexity are known to have originated in precisely the same way. (The similarities between psychoanalysis and the aesthetic process have been discussed by Freud, 1908); (Sachs, 1942); (Beres, 1957); (and Beres and Arlow, 1974.)

In addition to introspection and intuition there is a third process closely related to the way the analyst comes to understand the patient. This is the process of empathy. Empathy facilitates intuition, in fact makes intuition possible. It consists of a transitory or trial identification (Fliess, 1942) with the patient, followed by withdrawal and objective evaluation of the experience of identification. As described above, this takes place innumerable times in the course of the analyst's listening to the patient's productions. He is constantly changing his role from that of a passive recipient in identification with the patient to an active observer and interpreter of his experience, and thereby the patient's. The patient's productions impinge upon the analyst's mind in a manner corresponding to the way in which current realities, past experience, and transference determine which derivatives of the persistent unconscious fantasies will emerge into the patient's consciousess. The process may be compared to the relationship between current reality, i.e., the day residue, and the production of dreams. The shared intimacy of the psychoanalytic situation, the knowledge of secrets confided and desires exposed, intensifies the trend toward mutual identification in the analytic setting and, in the end, serves to stimulate in the mind of the analyst unconscious fantasies either identical with or corresponding to those decisive in the patient's conflicts and development. Analyst and analysand thus become a group of two sharing an unconscious fantasy in common, a feature which Sachs (1942) points out is distinctive for artistic creation.

The insight that comes from introspection, intuition, and empathy constitutes only the first part of the interpretive work. This is the subjective or aesthetic phase of the analyst's response. As intriguing and dramatic as it may be, it has to give way to a second phase of the interpretive process, one that is based on cognition and the exercise of reason. In order to validate his intuitive understanding of what the patient has been saying, the analyst must now turn to the data of the analytic situation. He must put his insight to the test of objective criteria in conformity with the data at hand." (pp. 201-202)

　

Jacob Arlow (1979). The Genesis Of Interpretation. Journal of the Amererican Psychoanalytic Association, Vol. 27S, pp. 193-206