"The first tradition views psychoanalysis as an effort to discover something true about the mind. That truth may be difficult to access and our methods imperfect, but the project assumes that a psychological reality exists and can be known, at least in part. Analysts in this lineage take for granted that human beings possess enduring inner worlds shaped by early experiences. They study drives, conflicts, defense mechanisms, object representations, personality, and psychopathology."
"In this view, the analyst is not a passive participant in a co-created narrative. Nor is the therapeutic process primarily a linguistic or cultural construction. Instead, the analyst uses empathy, interpretation, and sustained inquiry to help the patient understand the structure of the self: the configuration of internal objects, affects, fantasies, and conflicts that generate symptoms and interpersonal patterns. The philosophical basis of this approach is realism."
Two distinct philosophical lineages shape psychoanalytic theory and practice. One lineage treats analysis as discovery, assuming an objective psychological reality formed by enduring internal worlds, drives, conflicts, defenses, and object relations, with techniques oriented toward empathy, interpretation, and uncovering intrapsychic structure. The other lineage treats analysis as construction, emphasizing intersubjectivity, language, culture, and the co-creation of meaning within the analytic encounter, challenging claims of fixed intrapsychic truth. The distinction influences clinical technique, training, case formulation, and how clinicians conceptualize transference, countertransference, and therapeutic goals.
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