Tuckett D
Int J Psychoanal. 1994 Dec;75 ( Pt 5-6):1159-80.
This paper argues the case that validation in the clinical process depends to a large extent on being as clear and specific as possible about the hypotheses being put forward. In sessions interpretations are made based on intuitive and quite spontaneous links arising from background orientations and what will be called clusters of observed clinical facts. Outside the session, a wider and more developed set of grounded hypotheses can be developed, intended to illuminate what seem to be the core issues that arise over time and the core problems suffered by the patient. Often such hypotheses will only be in the form of working orientations. If they can be conceptualised more precisely into specific hypotheses explaining sets of observed events and predicting consequences, they can be better evaluated--either by the analyst working alone, or in group discussion through the achievement of genuine consensus. A process of building up a 'grounded' hypothesis, by making comparisons in the process of trying to solve a clinical problem, is described using detailed clinical material. This is also intended to illustrate the argument that it can be useful to consider the basic occurrences reported from sessions as data, distinct from the theory put forward to explain them.
本文认为，临床过程中的验证在很大程度上取决于对所提出的假设尽可能清晰和具体。在诊疗过程中，解释是基于背景取向以及所谓的观察到的临床事实集群所产生的直观且相当自发的联系做出的。在诊疗过程之外，可以形成一套更广泛、更完善的有根据的假设，旨在阐明随着时间推移出现的核心问题以及患者所遭受的核心问题。通常，此类假设仅以工作取向的形式存在。如果能够将它们更精确地概念化为解释一系列观察到的事件并预测后果的具体假设，那么就可以更好地对其进行评估——无论是由分析师单独进行，还是通过达成真正的共识在小组讨论中进行。本文使用详细的临床资料描述了一个通过在试图解决临床问题的过程中进行比较来构建“有根据的”假设的过程。这也旨在说明这样一个观点，即将诊疗过程中报告的基本事件视为数据是有用的，这些数据与为解释它们而提出的理论不同。
