The psychoanalyst's mind: from listening to interpretation--a clinical report.

Freud's delineation of 'psychical reality' as our investigative domain poses compelling epistemological and clinical challenges, which must profoundly affect our understanding of what is meant by what is real. Exploring the patient's inner reality as our central database, we are given a remarkable, but elusive opportunity for discovery and recognition, holding a pervading mutative power. It is elusive, for, despite our intentions otherwise, there is a continuing pull towards a belief in the greater 'wisdom' of our own assumptions and predilections, a blurring of the boundaries between our and our patient's vantage points, leading us away from essential, if subtler dimensions of the patient's experience. Utilising a clinical example, the author tries to illustrate some of her efforts to listen to her patient, and the difficulty she encountered. Her struggle was one which, she believes, has more far-ranging, even ubiquitous ramifications. Further consideration is given to some of the theoretical underpinnings in this mode of analytic listening.