Reconstruction and perceptual experience: further thoughts on psychoanalytic listening

Freud's monumental shift to the fantasy theory heralded the view that "it is psychical and not material reality" which is our sole domain of inquiry. Yet despite theoretical agreement and cogent technical admonitions against concerning ourselves with absolute or "external" truths, psychoanalytic listening betrays a stance in which the analyst attunes to a reality other than that of the patient's inner world, assuming the position of arbiter--even if a silent one--of what is or is not "distorted" in the patient's perceptual experience. The central impact of perception as a significant component of the patient's inner experience--past and present--goes unattended. Clinical examples from differing theoretical persuasions are reviewed to demonstrate this occurrence. An alternative mode of listening is considered which assumes an underlying shift in outlook, suspending any notion that we can "know" what is "correct" in the patient's perception, while sharpening attunement to its clinical impact--as may be evidenced by a shift in affect or state, a turn of phrase, or the transient appearance of a symptom or old behavior. It is argued that such a stance will lead to a more singular focus on the patient's psychic reality, permitting the emergence of a deepening realm of psychic phenomena, enhancing the capacity of self-observation, and richly facilitating the reconstructive process.