Otherness within: aspects of insight in psychoanalysis.

In this paper I consider moments of insight in which the subject consciously experiences the emergence of something alien within the self, usually of a drive-related, affective, and at times uncanny nature. These are crucial, yet neglected, experiences of insight within the therapeutic process. Such experiences do not fit easily into our theory, because usual descriptions of insight stress the ego's integrative capacities. I attempt to demonstrate how aspects of our theory that emphasize rational, narrative explanations, or the social construction of clinical facts, as well as those that emphasize the ego's integrative functions, may prevent our fully appreciating these experiences of insight in our patients.