Against understanding: why understanding should not be viewed as an essential aim of psychoanalytic treatment. 2010

Bruce Fink
Duquesne University, Pittsburgh, PA 15282, USA.

The current emphasis on understanding in psychoanalysis--on the analysand's part as well as on the analyst's--is excessive if we assume that the most essential aim of psychoanalytic treatment is change. Situated within the Lacanian register or dimension of the imaginary, the process of understanding can be seen to reduce the unfamiliar to the familiar, to transform the radically other into the same, and to render the analyst hard of hearing. Our ability as analysts to detect the unconscious via slips of the tongue, slurred words, mixed metaphors, and the like is compromised by our emphasis on understanding and can be rectified only by taking as our fundamental premise that we do not understand what our analysands are saying. The emphasis on understanding can also do a disservice to analysands, who learn to observe themselves and to explain their feelings and behaviors to themselves and others in sophisticated terms without necessarily changing. But change can perfectly well occur in the absence of understanding, which in fact often impedes change.

UI MeSH Term Description Entries
D009497 Neurotic Disorders Disorders in which the symptoms are distressing to the individual and recognized by him or her as being unacceptable. Social relationships may be greatly affected but usually remain within acceptable limits. The disturbance is relatively enduring or recurrent without treatment. Neuroses,Psychoneuroses,Disorder, Neurotic,Disorders, Neurotic,Neurotic Disorder
D010553 Personality Development Growth of habitual patterns of behavior in childhood and adolescence. Development, Personality
D010817 Physician-Patient Relations The interactions between physician and patient. Doctor-Patient Relations,Doctor Patient Relations,Physician Patient Relations,Physician Patient Relationship,Doctor Patient Relation,Doctor-Patient Relation,Physician Patient Relation,Physician Patient Relationships,Physician-Patient Relation,Relation, Doctor Patient,Relation, Doctor-Patient,Relation, Physician Patient,Relation, Physician-Patient,Relations, Doctor Patient,Relations, Doctor-Patient,Relations, Physician Patient,Relations, Physician-Patient,Relationship, Physician Patient,Relationships, Physician Patient
D011574 Psychoanalytic Theory Conceptual system developed by Freud and his followers in which unconscious motivations are considered to shape normal and abnormal personality development and behavior. Oral Character,Psychoanalytical Theory,Theory, Psychoanalytic,Character, Oral,Characters, Oral,Oral Characters,Psychoanalytic Theories,Psychoanalytical Theories,Theories, Psychoanalytic,Theories, Psychoanalytical,Theory, Psychoanalytical
D011575 Psychoanalytic Therapy A form of psychiatric treatment, based on Freudian principles, which seeks to eliminate or diminish the undesirable effects of unconscious conflicts by making the patient aware of their existence, origin, and inappropriate expression in current emotions and behavior. Balint Psychoanalytic Therapy,Psychoanalytic Therapy, Balint,Psychoanalytical Therapy,Therapy, Balint Psychoanalytic,Therapy, Psychoanalytic,Psychoanalytic Therapies,Psychoanalytical Therapies,Therapies, Psychoanalytic,Therapies, Psychoanalytical,Therapy, Psychoanalytical
D003142 Communication The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups. Miscommunication,Misinformation,Social Communication,Communication Programs,Communications Personnel,Personal Communication,Communication Program,Communication, Personal,Communication, Social,Communications, Social,Miscommunications,Misinformations,Personnel, Communications,Program, Communication,Programs, Communication,Social Communications
D005201 Fantasy An imagined sequence of events or mental images, e.g., daydreams. Day Dreams,Daydreams,Day Dream,Daydream,Dream, Day,Dreams, Day,Fantasies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013561 Symbolism A concept that stands for or suggests something else by reason of its relationship, association, convention, or resemblance. The symbolism may be mental or a visible sign or representation. (From Webster, 3d ed) Symbolism (Psychology),Symbolisms,Symbolisms (Psychology)
D014473 Unconscious, Psychology Those forces and content of the mind which are not ordinarily available to conscious awareness or to immediate recall. Psychological Unconscious,Subconscious,Unconscious (Psychology),Psychology Unconscious,Unconscious, Psychological

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