False memories, negative affects, and psychic reality: The role of extra-clinical data in...

©2005 Institute of Psychoanalysis

False memories, negative affects, and psychic reality:

The role of extra-clinical data in psychoanalysis1

aMICHAEL I. GOOD,2 bMAX DAY and cEVE ROWELLa74 Craftsland Rd, Brookline, MA 02467-2632, USA — [email protected]

b108 Lake Ave, Newton Center, MA 02459-2108, USA — [email protected] Elmwood Rd, Wellesley, MA 02481-1147, USA — [email protected]

(Final version accepted 19 May 2005)

Psychoanalysis as a treatment originated in the idea that neurosis is related to the ways in which individual psychic reality departs from actuality. Psychic reality includes memories, beliefs and their associated affects and fantasies connected with an individual’s experience of the inner and outer world. The psychoanalytic determination of what meaningful memories or beliefs are inaccurate, distorted or false ordinarily relies upon principles of intra-clinical validation. By itself, however, intra-clinical validation is subject to limitations and pitfalls that conviction alone about what is actual cannot circumvent. Despite this fact, there are remarkably few analytic case reports demonstrating false or signifi cantly distorted memories through the use of data obtained from outside the consulting room. This paucity of reports may be related, at least in part, to the belief that the use of extra-clinical data is essentially unanalytic or supports resistance. Based on the views that (a) psychic reality cannot be regarded as exclusively subjective or objective but is inherently both; and that (b) a goal of analysis is to achieve a different, acceptable and more accurate view of reality, the authors report a clinical case involving a confi rmably false pivotal memory and its associated negative affects. They discuss theoretical and technical considerations in utilizing extra-clinical data during the treatment process.

Keywords: false memory, psychic reality, fantasy, belief, extra-clinical data, actuality, reconstruction, distortion, resistance, veridicality

[O]ne cannot distinguish between truth and fi ction that has been cathected with affect.(Freud, 21 September 1897, cited in Masson, 1985)

I think I have always known about my memory: I know when it is to be trusted and when some dream or fantasy entered on the life, and the dream, the need of dream, led to distortion of what happened.

(Hellman, 1973, p. 112)

Psychic reality is the particular domain of psychoanalytic investigation. For the individual, it represents or determines that which is experienced as real or true (Laplanche and Pontalis, 1973; Arlow, 1985; Panel, 1985; Wallerstein, 1985). At the

Int J Psychoanal 2005;86:1573–93

1An abbreviated version of this paper was presented at the 41st IPA Congress, Santiago de Chile, 26–30 July 1999, and was awarded the 1999 Cesare Sacerdoti Prize.2Corresponding author.

1574 MICHAEL I. GOOD, MAX DAY AND EVE ROWELL

same time, psychic reality cannot be regarded as exclusively subjective or objective but is inherently both (Meissner, 2000).

As a human disposition, individual psychic reality does not itself entail the presence of psychopathology. Rather, much of what we call neurosis can be seen as the consequence of misconception, misperception, and even self-deception (Meltzer, 1991; Britton, 1995; Weiss, 1997)—consciously or unconsciously—leading to, and deriving from, distorted or false memories and misbeliefs that infl uence, and are part of, an individual’s psychic reality. Included in this view are the effects of trauma on the ego, the infl uence of defense, and the role of fantasy (Khan, 1964; Arlow, 1969a, 1969b). Although felt with great conviction (Joseph, 1973; Good, 1998), the internal reality represented by a patient’s memory or belief, including concomitant affects, at times can differ remarkably from the corresponding historical actuality as it comes to be understood in the course of analysis (Kris, 1956; Arlow, 1996). This distinction between realities is clinically telling and may even be crucial to a particular analytic endeavor (Reed, 1993; Shapiro, 1993; Good, 1994a). Specifi c reconstruction (or deconstruction) of memory-fantasy complexes pertaining to past events ideally involves, in so far as possible, the specifi c delineation of the event and the associated fantasies in order to establish its meaning (e.g. Reed, 1993).

Consequently, psychic reality and the extent to which it can represent distortions of external reality are of central importance in psychoanalysis (e.g. Gabbard, 1997). However, despite the considerable controversy regarding the subject of ‘false memories’ and ‘recovered memories’ over the past 20 or so years, there are remarkably few clinical case reports on the general subject of false memory in the psychoanalytic literature (see Good, 1994a, 1999; Sandler and Fonagy, 1998). Moreover, it is our impression that considerable psychoanalytic literature on the subject of reconstruction has actually been antithetical to employing available data from outside the analytic hour, despite its poten-tial usefulness in the analytic process. The sparsely reported use of extra-analytic data appears to stem, at least in part, from the dual notions that psychic reality is equivalent to fantasy and idiosyncratic belief alone, resulting in the virtual exclusion of relatively objectifi able sources, and that attention to external data may serve as a resistance to analytic process. As a result, many analysts declare or imply a lack of concern with, and even a disdain for, external reality in the course of analysis (see discussion in Hamilton, 1996; Meissner, 2000; and ‘Technical considerations’ below).

This report (1) explores the nature and function of a pseudomemory3 and its associated negative affects; and (2) considers technical aspects of the potential

3Although historically unrealistic or preponderantly inaccurate recollections are commonly referred to as false memories or pseudomemories, there are problems with these terms. Memory, in general, can have both true and false elements (Allen, 1995). Alternatively, after Myers (1884, 1903), the term falsidical, an antonym for veridical, could be applied. Whereas a memory refl ecting inner reality is psychically true even if it is essentially false historically (materially), the term falsidical specifi es that the memory lacks correspondence to an actual event. This term thus has the advantage of entailing a comparison of types of observational data that may help obviate bias in assessing the relative importance of, and interrelationship between, internal and external realities. It may thus be a less judgmental term than false. In addition, although Freud (1937) used the term historical in the sense of actual, he also wrote of historical truth as distinct from material truth (1939, p. 129), refl ecting the fact that psychic truths infl uence our sense of historical truth.

1575FALSE MEMORIES, NEGATIVE AFFECTS, AND PSYCHIC REALITY

therapeutic use of extra-analytic data, which may more accurately represent or approximate material reality as it contrasts with the patient’s psychic reality. Indeed, psychoanalytic and psychoanalytically oriented treatment is based on the fact that psychic reality is mutable and subject to an interplay of subjective and objective infl uences (Meissner, 2000). It is hardly our intention to advocate a ‘naïve realism’ but rather to recognize the ultimate desirability of a correspondence between memories (or constructions) as they evolve during treatment and possibly available extra-clinical data, i.e. ‘critical realism’ (Fitzpatrick Hanly, 1996). Likewise, we do not believe that ‘the analyst must choose between reality as totally objectively discoverable and reality as relative, subjective, and unknowable’ (Inderbitzin and Levy, 1994, p. 776, quoted in Oliner, 1996, p. 274). We are thus in agreement with Inderbitzin and Levy (p. 777) that there is a broad middle ground that acknowledges the importance of subjectivity and the possibility of a consensually validatable ‘objective’ reality. What we question is the argument that the introduction of external reality into analytic process necessarily or ultimately serves resistances (even though it may at times) and is thus to be eschewed by the analyst or to be seen solely as an avoidance of analytic process when introduced by the analysand—even if done so for reasons that ostensibly promote analytic understanding. The related converse question is whether, using intra-clinical data alone, everything ultimately can be analyzed, and done so with resultant genuine conviction in the analysand. An open-minded analytic approach that cautiously considers a balanced and selective role for potential external data in analytic process may serve both the individual analysand and, in a more general sense, the elaboration of psychoanalysis as a scientifi c disci-pline (Edelson, 1984; Good, 2005).

Memories and beliefs: Conviction and the question of veridicality

Conscious memories are experienced as corresponding or relating to events, whether external or internal. Even dreams have a day residue. Thus, in an individual’s epis-temology or way of assessing knowledge, memories more readily tend to be viewed as ‘objectively true’ or veridical than do conscious beliefs occurring without an associated memory (for examples of the latter, see Shengold, 1991; Raphling, 1994; Prager, 1998). This distinction between memory and belief particularly applies to individuals with the potential for a degree of philosophical skepticism about their conscious beliefs. On the other hand, perception itself is infl uenced by belief, and memories may be invented unconsciously in support of a belief (Tenzer, 1985). Such beliefs generally correspond to strong and unconscious affectively charged experiences. To the extent that a difference in conviction about memories and beliefs exists, this difference can occur because the experience of memory generally involves some perceptual basis for the presence of the memory. The reality basis of certain memories, such as early screen memories, may be strongly held, but it can also exist with a degree of doubt (compare déjà vu [Good, 1998]). Screen memories are often condensed, distorted, or false, but they can also be essentially true, even if at times trivial or indifferent in their manifest content.

In the analytic situation, it usually is not clear when, or to what extent, a particular memory and the historical actuality to which it relates differ, overlap,


or coincide. Indeed, it is rare that cases detailed in the literature describe either a pre-existing or a recovered memory or a reconstruction which has been verifi ed to be essentially contrary to historical actuality (Good, 1996, 1998). This problem in knowledge goes back to the origins of psychoanalysis. Even though Freud high-lighted the distinction between fantasy and external reality in his early modifi cation of the seduction theory, and although he continued to struggle theoretically with the roles of psychic and material reality in psychopathology (1899, 1901, 1910, 1914, 1937), he and his colleagues apparently did not illustrate the basis for rejecting the original trauma theory through the use of detailed case studies (Good, 1995). Nor, to our knowledge, have there been more than a handful of published analytic cases of recovered memories or reconstructions of early trauma in which the event could be verifi ed with extra-analytic data (Brenneis, 1997, and personal communication, June 14, 1997; Good, 1998, 2005; cf. Rosen, 1955; Novey, 1964; Share, 1994). As Good noted previously,

Although Freud tended to minimize the uncertainties of his interpretive methods (Rubovits-Seitz, 1994), he did believe in the usefulness of extra-clinical data in the validation of psychoanalytic reconstructions. Unfortunately, even since Freud, the psychoanalytic literature in general has given limited attention in case-specifi c reconstructions to the issues of whether an event was ‘real or fantasied, actual or plausible, specifi c or generic, a past reaction or a current derivative’ (Wetzler, 1985). In the ongoing search for supporting clinical evidence for psychoanalytic reconstructions, Heinecke (1970) cautioned that ‘even if the perspective of the analyst is many-sided and longitudinal, it may all be distorted by premature conclusions and theoretical biases that do not really provide an accurate “fi t”’. (1996, p. 1196)

This scarcity of specimen cases demonstrating historical actuality in comparison to psychic reality is rather remarkable, given the momentousness of Freud’s dis-coveries for our intellectual history, and the fact that over a century has elapsed since Freud fi rst concluded that false memories were based on fantasy or psychic reality—what he originally referred to as ‘thought reality’ (1895, p. 373). Novey’s papers (1964, 1966) on the subject of actual historical data in psychoanalysis are among the rare discussions of this topic. And yet, as Blum (1994) more recently observed, many patients fi nd themselves talking to relatives about their childhood, attending to old photographs or home movies, recovering mementos of childhood, visiting old homes and cemeteries, or unearthing diaries and letters of long ago (for example, see Bonaparte, 1945; Flumerfelt, 1962; Serota, 1964; Viederman, 1995; Castelnuovo-Tedesco, 1997). These outside sources may add conviction to reconstruction or memory, although not without transferential import. Sometimes outside sources may contradict otherwise credible memories or beliefs.

More commonly, the analyst and patient by themselves—or perhaps only one of them—serve as arbiter of the reality of the patient’s memory or the veridicality of a reconstruction, whether rightly so or not. Determining whether the reconstruction is veridical, as opposed to a convincing yet false or falsidical screen reconstruction (Good, 1998) may be diffi cult. Usually, the validation of a reconstruction is based upon the confl uence of a number of intra-analytic sources of data that are seen as tallying. The problem of reconstructive uncertainty has even led to proposals of criteria on which to base decisions regarding historical truth (Arlow, 1996, p. 665;


Brenneis, 1996; Friedman, 1997, pp. 119–20). At times, the patient fervently asks the analyst whether he/she believes the patient’s memories. In trying to sort out what is ‘real’, the analyst then faces the dilemma of either maintaining technical neutrality or managing a seemingly fragile working alliance, one of these possibly having to be sacrifi ced for the other (Sarnat, 1997; Hoffer, 1999).

Notwithstanding the patient’s felt need for validation, the analyst’s expression of belief in the patient’s memories may serve as a powerful suggestive infl uence that itself affects recall (Good, 1996; Brenneis, 1997). At the same time, undue skep-ticism about a patient’s memories may represent a countertransference response. Furthermore, in addition to the fact that certain historical data are elusive or diffi -cult—if not impossible—to obtain, some analysts consider the use of extra-analytic data to be counterproductive or unanalytic (Faimberg and Corel, 1990; Inderbitzin and Levy, 1994), preferring to focus exclusively upon psychic reality. Often we have no way of knowing whether a memory or construction has some actual basis, and so we proceed as best we can with the patient’s associations, memories, dreams, and the transference. But to restrict the focus to intra-clinical data alone when a chance to consider extra-clinical correlations or data arises can be a lost opportunity.

As Oliner (1996) contrasted, there are those who are convinced that psychoanalysis must dispense with external reality while others believe that more of it has to be introduced. She perceptively makes a strong case for the analysis of psychic reality while at the same time emphasizing external reality—an apparent contradiction (or dialectic) having to do with the crucial importance of whether something is real or imagined (p. 276). Still, she does not share the view of those current analysts who actively reintroduce external reality into the treatment, since this approach could be motivated by a guilt, generated by the widespread notion that classical analysis is accusatory and blames the victim. As she therefore contends, the importance of external reality remains to be assessed. While regarding the use of external reality primarily as a defense, Inderbitzin and Levy do note that

analysands make use of reality factors to help them manage both the oscillation between experiencing and thoughtful, rational contemplation during sessions, and the shifts into and out of an analytic mode required if analytic work, with its sometimes intense emotional upheavals, is to fi t into their everyday lives. (1994, p. 767)

Attuned to matters of belief and suggestion in the retrieval of traumatic memories, Brenneis (1997) has focused particularly on traumatic memory experi-ence that had not previously been conscious. In contrast, he observed that explicit autobiographical memory which has been more or less continuously available prior to any therapeutic encounter warrants validity without reservation (p. xi). In general, one might not likely doubt or question plausible memories of this continuous kind. However, Greenacre (1975) has warned about taking at face value recollections that are potentially screen memories or pseudomemories—see, for example, Good’s (1994a) case and Piaget’s memory of his own kidnapping in childhood (Piaget, 1973; Bringuier, 1980) as plausible ‘continuous’ memories that turned out to be false.

In the current, reinvigorated controversy about the reliability of memories of trauma (for example, Schacter, 1995, 1996; Brenneis, 1997), the possible truth or


falsehood of memories as recalled by the patient, on the one hand, and reasons for acquiring data about the actual past, on the other, touch upon theoretical and scientifi c issues for psychoanalysis. The questions involve the comparative roles of the actual past, including traumatic experience, and psychic reality in determining psychopathology (Kirshner, 1993), as well as the evidential basis for making infer-ences based on intra-analytic data alone (Good, 1998, 2005). Thus, the need for detailed specimen case studies that include external data and permit readers to draw their own conclusions about the actual past is paramount in establishing a fi rmer scientifi c base for psychoanalysis that relies not only on confi rmation but also on falsifi cation of intraclinical constructions.

A false memory and the avoidance of negative affects

The following case illustrates a plausible memory that turned out to be false. In this case, an analytic patient sought out historically objective information on her own, without input from the analyst, as a means of corroborating an insight that advanced an intrapsychic focus of the treatment. In other instances, the analyst or therapist may suggest the availability of outside information relevant to the treatment process (Good et al., 2005). It is our view that, while the technical issues regarding how extra-clinical data are introduced and dealt with will vary among different cases, the occasional, judicious, or serendipitous use of such data has the potential for further-ing the treatment process without necessarily contributing to treatment resistance. It is not our intention to imply that any particular memory, particularly those associ-ated with traumatic experience, is necessarily likely to be untrue. Indeed, external data can also be used to corroborate memories or psychoanalytic reconstructions, as well as to falsify them. Often, however, especially when a memory or reconstruction is plausible or convincing, falsifi cation can lead to great surprise and may further the treatment in unanticipated ways.

Ms A: Loss of a child and a change in the weather

A 42 year-old married woman was referred by a psychotherapist who felt she would benefi t from psychoanalysis. Ms A sought treatment for several reasons, including problems with a distant husband, unresolved grief over the death of her fi rst child over 20 years earlier, and low self-esteem. The analysis was four times a week, using the couch. This case vignette focuses on a false memory involving a sense of culpability that she had apparently maintained for over 20 years.

At age 20, while still in college, she had married. Ten months later, in April of her sophomore year, she gave birth to a baby boy. In subsequent years, she had three other children. However, because she had hoped to complete her schooling, she did not welcome this fi rst baby and was constantly burdened and angry at him. One day that spring, she put him out on the veranda for fresh air on what she described as a cold, windy day, and he died. She blamed herself for his death because of the inclement weather and for having raged at him for coming uninvited in the fi rst place. To make matters worse for her, she found out that her analyst (MD) had a son with the same name as her own fi rst-born, and so the pain increased each time she


overheard his wife calling their son by name as she passed by the hallway door to the kitchen on her way upstairs to his home offi ce.

In the early phase of the analysis, she saw her analyst in ambivalent terms: she felt he was actively interested in her wellbeing yet could not see how he could bear her. She looked down on herself for constantly trying to control her husband and her children. At the same time she blamed herself for the loss of her fi rst child, and mourned this loss with great diffi culty. More and more, she cried in the sessions about him. She wanted her husband to go with her to the cemetery to the baby’s grave, but he reportedly was reluctant to accompany her, and so the analysis became the vehicle for her grieving. On the one hand, she hated the baby for interfering with her work at school, and, on the other hand, she felt at fault for his death. She recalled the police coming, paramedics trying to start his heart with an injection, and the fact that he was all blue. She wished she had a picture of him. All she had left was the blue outfi t he had worn—nothing else. Memories about her fi rst-born son were crescendoing in the hours.

Just before the 74th session, she had been arguing with her husband. In the waiting room, as she heard her analyst coming up the stairs to the offi ce, she grew sad. In the hour she wondered, ‘Did my wish that he get pneumonia cause his death? Don’t you ever get mad at me? Each time I abuse you verbally you tolerate it. Don’t you despise me? You mean more to me than when I began here. You made me think of the baby, you and your son, and I feel obnoxious and fi ght you. I thought I’d resent him for the rest of my life. I was never able to want him. But now I want him. I wish I could hold him once again. I made a mistake with my son. I had taken him to the doctor two or three days earlier. Everything was OK. If I hadn’t put him on the porch, would he have died anyway? He was dressed warmly. It was March’.

Then, for the fi rst time hearing the meaning of her words, she corrected herself, realizing that he was born in April.

Patient: March was when my husband got his ulcers. He wasn’t born until April, not March. So it must have been June when he died. It was cold out then.

Analyst (clarifying): You don’t die from being outside in June if you are dressed warmly. A cold June day doesn’t kill.

P (as the session concluded): Hmm. Was it my thoughts that made it a bitter cold day in March?

In the 75th hour she described having had great emotional pain over the weekend.

P: I made a big discovery here last time. I can hardly even talk about it. All these years I thought I caused his death. I really did take care of him. I’ll fi nd other reasons to blame myself. But after the last session I called the Weather Bureau to get the weather report for the day in June when he died. They’ll send it to me. It couldn’t have been that cold in June. My mother kept us in from the cold. I put him out and got punished. I’d be more careful with an infant. Ever seen a blue baby? How long do they stay blue after they die? Babies die of fl ash pneumonia in cribs—the


doctor’s name for it. It’s hard to say his name. Why do I have such trouble being tender with my husband? Did he ever feel guilty? I doubt it. If I weren’t in analysis, I’d never have known my son. So he didn’t die in March. He didn’t die in March. All these years I thought it was March, that I’d put him out in the cold, and he’d died. The house was full of policemen. They kept me away from him. Now I’m afraid to get the weather report. It won’t matter no matter what the temperature was. How hard it is to listen and put the things together. How awful to see a blue baby. Is it possible I could believe that his death is not my fault? I can’t say it wasn’t. I can only ask if it wasn’t. I want you to tell me it wasn’t my fault. If you said it, that is what would count. Now it’s easier for me to say his name. How did you get me to change how I feel about him?

A: You’ve been facing your feelings.

How could it be as cold in June as she had imagined, she now wondered. How had she remembered it as March? Those questions triggered her calling the US Weather Bureau and learning the historical truth. The information from the Weather Bureau arrived shortly in the next weekend mail, and she was stunned and relieved to learn that it had been a warm and pleasant day of about 70 degrees Fahrenheit, with gentle breezes. Cold weather had not killed him. Nor had her anger. Although she passingly claimed that it ‘won’t matter what the temperature was’, the reality did matter in sorting out her experience of the traumatic loss. The death apparently was due to sudden infant death syndrome (SIDS).4 As a result of talking in the analysis about the death and her sense of guilt, she had the opportunity to listen to herself and hear what did not make sense. The baby had died in June, and she had been saying what a cold and windy day it had been, as if it had happened on a March-like day, although the baby had not been born until April. Confi rming her false recollection about the weather conditions with an actual report helped her to address the intra-psychic reasons for the false memory. She voiced her realization that she actually must distort memories, and she observed how she has to censor some things to tell other things. There were also masochistic features in her history that contributed to her belief in her badness and guilt.

In the hours following her realization about the weather, with her conscious experience of an amelioration of guilt, the issue of the loss of her fi rst-born son began to recede—even though it did not disappear—and she began to talk more about current concerns, particularly in her marriage. As she came to grips with her heretofore unresolved ambivalence about her lost son, she noted how her feelings about him had now shifted. Recognizing her aggressive feelings toward him yet realizing that she had not actually killed him, she was better able to mourn.

4The death certifi cate specifi ed ‘suffocation’, which was how SIDS deaths were specifi ed at that time. However, the baby reportedly had nothing over his face when she found him, nor was there a pillow or other adjacent item that could have suffocated him. It is noteworthy that ‘suffocation’ itself can be a guilt-inducing term. Although recent news items have sensationalized the questioning of potentially premature diagnoses of SIDS (cf. O’Halloran et al., 1998), especially in sequential cases, the patient’s other children fared well, and the analyst had no reason to doubt that the death was due to SIDS.


It came to be understood that when, by chance, the baby died and gratifi ed a death wish toward him, she converted her murderous anger and guilt, by projection, into a memory of terrible weather killing him. Britton (1995) observed that problems in distinguishing material from psychic reality are related to a marked diffi culty in relinquishing objects. Retaining a memory or belief that is untrue may thus serve the purpose of emotionally holding on to the associated object. What was especially settling about this denouement was that she decided on her own to fi nd out what the weather had truly been. The analyst himself did not question or doubt her recollec-tion, nor did he recommend that she check out the old weather report. He had not had an opinion whether the baby’s death was due to an accident or negligence, and her calling the Weather Bureau came as a surprise to him.

Because she had come to acknowledge within the transference some of her old guilt feelings about her baby’s arrival and death—and did not feel blamed by her analyst—she was able to bestir herself to ascertain and bear the truth more realistically. In this way she became able to distinguish fantasy and reality, and to grieve the actual traumatic loss (Freud, 1917a). The case illustrates the signifi cance of actual history in psychoanalysis (Novey, 1964) and why some patients conduct actual investigations of the past (Novey, 1966). It also illustrates how signifi cantly false autobiographical memories need not be only from childhood. While there was more analytic work to be done in Ms A’s psychoanalysis, the realization that she had not actually done something to cause the infant’s death helped to free up the analytic process and to clarify the role of irrational guilt feelings in her other relationships and in the transference. While her documentary investigation can be seen as an enactment, it had more than one consequence. Not only did it help to underscore the transferential aspect of her expectation of blame and guilt, but it also allowed other analytic material to enter more freely into the sessions and to permit the further recognition of transference phenomena that could be understood and accepted with greater conviction.5

In a post-analytic follow-up, the patient described how, over the years, she often thought about, and vividly remembered, the pivotal analytic event in which she reported the corrected memory and fi nally concluded that it was not her fault. Although she had participated in offering explanations for the distorted memory and its correction, to her there was an impact in the corrective experience that was beyond explanation.

Alterations and corrections of perception and memory

The ‘correction’ of mental distortion by means of dealing with resistances in the transference has been a therapeutic objective of classical psychoanalysis. As Freud

5In his discussion of this paper that was presented at the Congress of the IPA in 1999, Harold Blum raised the question of whether the patient had a transference to the analyst as a ‘cold and windy day’ that she subsequently was able to distinguish as transference. While this observation could, in part, explain what led to her checking out how the weather had actually been and who the analyst really was, her conscious experience of him had been more that of a benign, listening fi gure with whom she came to better recognize her own grief and sense of guilt. Genetic aspects of a negative superego transference would take longer to evolve and required clarifi cation of her manifest guilt feelings.


affi rmed, ‘We have long observed that every neurosis has as its result, and therefore probably as its purpose, a forcing of the patient out of reality, an alienating of him from reality’ (1911, p. 218). Fenichel (1945, p. 26) commented that it is the task of the analyst’s interpretative work to undo and make retroactive the distortion caused by resistances, but he also asked how the analyst can know what the words of the patient actually allude to, how the analyst can really know what is distorted.

More recently, Shevrin (1994, p. 995) stated that, as long as we do not possess clear-cut ‘indications of reality’ (Freud, 1911) by which we can judge any com-munication, then a ‘reasonable guide to accuracy and reliability’ includes a general assessment of a patient’s capacity for reality testing and a knowledge of where defensiveness is likely to be at work ‘alienating him from reality’. Although this guide often may be reasonable, it is certainly not foolproof. It may even be mislead-ing in those cases in which memory, defensiveness, and suggestibility intermingle in complex ways that are diffi cult to tease apart and lead to convincing, albeit errone-ous, constructions. Of course, as Shevrin clarifi ed, adult recall of childhood events is not uniformly unreliable and tendentious, and it can be remarkably accurate under certain conditions, and at quite early ages, such as for signifi cant milestones like the birth of a sibling (1994, p. 992). Although not everyone’s memory is subject to suggestion, he mentioned cognitive research fi ndings that one person in four has memories that can be manipulated by suggestion, a fi nding he believes most analysts could support with further evidence from their practices (p. 993). Shevrin concludes from this observation, however, that ‘only a minority can be manipulated by sugges-tion’. Still, one in four is a considerable percentage of patients, even if a minority. And, even if memories reported in psychoanalysis do not appear to be due to direct or overt suggestion, they can be due to indirect or covert suggestion, represent early misperceptions, or serve as a screen. Consequently, what is a ‘reasonable guide to accuracy and reliability’ may not be obvious.

Overt attempts to infl uence or correct a patient’s presumed distortions may necessitate departures from the goals of neutrality (see Hoffer, 1999) and analytic attunement (Schwaber, 1997), and thus may pose analytic risks. Such attempts may be ill advised. At the same time, in recent years attention has turned toward the infl uence of the analyst (Raphling, 1995; McLaughlin, 1996; Schafer, 1996; Cooper, 1997) and the suggestibility of the patient in making a reconstruction, especially reconstructions of trauma, as well as the question of veridicality. Currently, there are a number of unanswered questions involving reconstructions and the recovery of traumatic memories and their truth value (Good, 1996, 1998, 2005; Brenneis, 1997). Even in the analysis of defense and presumed distortion, the analyst chooses what to address and thereby implicitly infl uences the patient’s experience of the analyst (Levy and Inderbitzin, 2000, p. 753).

In the patient’s transference experience, the analytic situation and the real person of the analyst can be viewed as ‘external reality’ vis-à-vis the patient’s psychic reality. Indeed, the analysis of transference is pivotal in resolving and modifying the patient’s maladaptive psychic reality. (For relatively recent expositions on this topic, see Caper, 1997; Gabbard, 1997). Here, two aspects of psychic reality can be distin-guished: the patient’s psychic reality as opposed to another’s (e.g. the analyst’s)


and psychic as contrasted with objective reality (Schwaber, 1997). Neither the patient’s nor the analyst’s psychic reality is necessarily objective, but a perceptual discrepancy between patient and analyst is a signal for investigation, not judgment about who is correct (Rosenblatt, 1997; Good, 1998). This need for analytic inquiry also applies to the potential introduction of extra-clinical data that are contrary to (or confi rmatory of) the patient’s psychic reality. Clinically and epistemologically, it can be said that the psychoanalytic method primarily works by ‘counterinduction’, that is, ‘by allowing the patient to attain at the basic observational level an ostensive re-evaluation or refutation of their previously unconscious theories [memories and beliefs]’ (Ahumada, 1997, p. 527). In other words, analysis works largely through a process of falsifi cation of the patient’s memories and cherished beliefs (see also Weiss et al., 1986; Good, 1994a, 1994b; Weiss, 1997).

Technical considerations

Inderbitzin and Levy observed, ‘It is surprising how little has been written about the role of external reality in neurotic confl ict and its effect on psychoanalytic technique’ (1994, p. 767). Various analysts have presented reasons for neglecting or avoiding greater attention to historical actuality within the analytic process. Not long ago, for example, writing on the recovered memory debate, Fonagy and Target asserted that ‘there can be only psychic reality behind the recovered memory—whether there is historical truth and historical reality is not our business as psychoanalysts and psychotherapists’ (1997, p. 216). Similarly, Wolf affi rmed his belief that

[we] can and must accept the analysand’s perceptions and beliefs as true, even though we know they are shaped by his experiences, biases, and unreliable memory, as well as by all kinds of conscious and unconscious motivations; we must accept the analysand’s truth because truth is only what is experienced as true. At a suitable time it may perhaps be appropriate to educate the analysand that others may experience a different truth, but almost invariably he knows that already and is likely to feel such educational efforts as insulting his intelligence. Since the actuality of the past, how it happened, and how it was experienced is never ascertainable with any high degree of reliability, let us admit this regrettable state and look upon the assertions in the present as communications about the present state of the communicator’s psyche. (1991, p. 103)

Wolf’s assertions certainly refl ect a need to respect the patient’s psychic reality. And, while tentatively raising the possibility of entertaining actuality, he then is nihilistic about the possibility of ascertaining reliable historical data. If it is presumed either that we can never know or that reality is equally relative, openness to the possibility of obtaining extra-analytic data is diminished, and psychoanalysis then sees itself as invariably having to settle at most for coherent narratives (see Spence, 1982). As Oliner (1996, p. 274) observed, an important difference between Freud’s time and ours lies in the overarching doubt about our ability to assess any reality other than subjectivity (cf. Dunn, 1995).

A second argument for either maintaining a focus on the here-and-now, attending strictly to the patient’s psychic reality, or constructing narratives of the past without considering historical actuality, is based on the need to establish or maintain a fragile therapeutic alliance and process (see Viederman, 1995; Sarnat, 1997). Even a


carefully introduced and well-timed neutral question bearing upon historical actuality might be seen as a potential cause of narcissistic injury, rupture of an empathic tie, or repetition of past trauma of being disbelieved. Sachs (1967) described how the belief and acceptance of the memory by the analyst results in an exhilarating feeling of relief—‘at last someone does believe me’. At the same time, ‘obsessional self-doubt’ that affected reality testing diminishes (cf. Viederman’s case, 1995). Those who work within a ‘belief paradigm’ (Brenneis, 1997) do not report seeking or considering questions of validation beyond internal consistency. However, the possibility that the patient’s psychic reality may covertly change as a result of direct or indirect suggestive infl uence, or the development of a screen reconstruction during psychoanalysis, are potential complications of this attempt to avoid jeopardizing the alliance (Good, 1996, 1998).

Third, attending to the availability of extra-clinical data may be seen as a resis-tance to analytic process. For example, Faimberg and Corel argued,

In many cases … patient and analyst share the intuition that there is a material basis for the facts related … [However], the information produced by an outsider would not be relevant from a psychoanalytic standpoint, but, on the contrary, would place an obstacle in the way of discovering the link between the facts and the patient’s psychic structure. (1990, p. 418, original italics)

Inderbitzin and Levy (1994, p. 277) warn of turning to external reality, includ-ing ‘outside grist for the mill’, as a means of defending against observing and fully experiencing intrapsychic pressures. Although their focus is on a defensive overemphasis on the interactively ‘real’ in psychoanalysis, their argument can be understood as extending to historical reality as well.

Similarly, Gray (1994, pp. 27–61) has warned of a preoccupation with external reality, including past as external reality—a kind of persisting ‘archeological dig’ motivated by suggestive infl uence—that constitutes a lag in analytic technique. (Gray qualifi ed his thesis, however, by adding that he is not an across-the-board antireconstructionist, and that there are varieties of reconstruction that he fi nds compatible with and essential to the technique of defense analysis.) He observed that, when confronted with a therapeutic approach that asks them to look inward, some patients become ‘reality-bound’. Here Gray (1994, p. 54) cited Freud’s famous dictum that ‘in the world of the neuroses it is psychical reality which is the decisive kind’ (1917b, p. 368).6 Indeed, undue focus on external reality can be a resistance. Yet, as Meissner (2000, p. 1134) clarifi es, the scope of psychic reality includes not

6Freud’s aphorism about the decisive role of psychic reality needs to be seen in context. Seeking to address and perhaps unify the theoretical duality involving external and internal realities, Freud argued that ‘we should equate phantasy and reality and not bother to begin with whether the childhood experiences under examination are the one or the other’ (1917b, pp. 367–8). But in 1917 Freud was attempting to underscore the role of patients’ fantasies in contrast to their ‘low valuation of reality’ in the path to symptom formation, a clarifi cation he repeated in 1923. With this dictum about the role of fantasy, his authority evidently furthered a group conclusion and belief among many psychoanalysts that reports of seduction were based on fantasies alone. Yet what Freud evidently was explaining is that, in the neurotic patient’s mind, fantasy dominates over external reality, in so far as they are both elements of psychic reality.


only subjective awareness and experience but also external reality as objectively perceived and evaluated. When psychic reality is at substantial variance from clearly discernible actuality, or from the analyst’s view of reality, their distinction takes on clinical relevance (Freud, 1937, p. 269; see also Fitzpatrick Hanly, 1996; Good, 1998). The analytic dialog occurring between two psychic realities may even take a dramatic shift when the analyst can see as objective something initially thought to be only the analysand’s projection (for a recent example, see Meissner, 2000, pp. 1129–32). The patient, as well as the analyst, may need to investigate external reality as a clinically relevant activity, which itself can be non-critically analyzed as to its possible defensive meaning. The proper use of extra-clinical data can further the analysis of defenses by increasing the patient’s recognition and conviction regarding the presence and role of defenses against reality.

Fourth, by raising questions about aspects of external reality, the analyst’s words may constitute a direct or indirect suggestion to the patient that some analysts deem unanalytic in so far as it may be utilized in overcoming resistance rather than analyzing it (Gray, 1994, p. 68). However, an explicit suggestion that is either direct or indirect regarding consideration of extra-analytic data could be viewed as a necessary modifi cation of technique that actually facilitates certain analyses (see Reed’s case below), particularly in cases with severe superego pathology and more primitive defenses that substantially resist an unmodifi ed approach—thus, see Gedo’s misgivings about Gray’s preference for an unmodifi ed approach (Gedo, 1999, pp. 115–6).

The modifi cation itself is subsequently subject to analysis. The judicious use of suggestion with appropriate timing and dose may have more benefi ts than drawbacks in certain analyses. The technical requirements involve respecting the patient’s psychic reality while at the same time attempting to involve the patient in the possibility of a different viewpoint. In certain other cases, patients pursue extra-analytic data independently, without the analyst’s overt suggestion. Some degree of implicit infl uence by the analyst is, of course, virtually impossible to eliminate, but these infl uences themselves can be examined (Good, 1996), particularly when there is openness to their occurrence.

On a historical note, Freud appears to have been ambivalent about the role of extra-analytic information. On the one hand, he believed that information that does not come directly from the patient is interfering (störend) (Manuscript Division, Library of Congress, Washington, DC, 6 June 1912, cited in Falzeder, 2000). He cautioned that pointed inquiries by patient or analyst made to relatives of the patient might elicit responses that are contaminated by the relatives’ misgivings:

So it may seem tempting to take the easy course of fi lling up the gaps in a patient’s memory by making enquiries from the older members of his family; but I cannot advise too strongly against such a technique. Any stories that may be told by relatives in reply to enquiries and requests are at the mercy of every critical misgiving that can come into play. One invariably regrets having made oneself dependent upon such information; at the same time confi dence in the analysis is shaken and court of appeal is set up over it. Whatever can be remembered at all will anyhow come to light in the further course of analysis. (Freud, 1918, p. 14, my italics)


Freud’s caveat is reiterated by Gutheil and Simon:

Attempts to go outside the therapeutic frame of the dyad commonly represent a problem of the countertransference and are almost always ill advised, because they shift the therapist’s focus into the external world where the number of variables confounds the therapeutic task. (1997, p. 1406)

Such extra-clinical pursuits of truth could represent a threat to the treatment alliance, a failure of empathy, or a disbelief in the patient’s statements. On the other hand, although introducing extra-clinical data could represent these countertransference problems, it does not necessarily do so. In certain cases, if done prudently, it may constructively represent a necessary means of addressing the complexities of arriving at analytic truth in a manner that empathically attends to the vicissitudes of psychic reality and furthers the treatment alliance. To grasp their psychic reality fully, patients need to recognize the subjective and objective elements of psychic reality, including, in so far as possible, the ways in which these elements intertwine.

Freud, in fact, returned to a consideration of historical actuality in his 1937 paper on constructions, when he reiterated ‘the power [of] the element of historical truth’ (p. 269, original italics) in patients’ memories and beliefs. External infor-mation (whether old or recent) need not be a resistance or derailing threat to the treatment, and it can provide rich opportunities for analysis. Describing his experi-ence with patients bringing in photographs and similar documentation, for example, Castelnuovo-Tedesco noted how such a behavior may be regarded as a resistance in which the analyst’s focus on understanding the meaning of the enactment rather than on the information or insights that might be gleaned from the material presented (1997, p. 662). Although the introduction of documentary items into the analysis may be an expression of a strong positive, as well as a negative, transference, such documentation, like the ‘picture worth a thousand words’, can clarify, broaden, and intensify the analytic work. The patient as ‘coinvestigator’ may seek to rekindle memories that are remote, incomplete, or misconstrued. This documentation, Castelnuovo-Tedesco indicated (p. 668), highlights the patient’s conviction that a ‘real’ past exists, even if it is no longer fully or reliably available to recall. As Freud put it, ‘What we are in search of is a picture of the patient’s forgotten years that shall be alike trustworthy and in all essential respects complete’ (1937, p. 258). In Castelnuovo-Tedesco’s experience, patients typically bring in items like photographs when some serious efforts at reconstruction have taken place or are about to take place. The question he raises is not only why, in our analytic work, some patients bring in documentation, but also why more patients do not do so. Perhaps too often the answer is that it is considered ‘unanalytic’.

Reed’s (1997) case illustrates how external reality can be introduced and pro-ductively used analytically. In this example, the analyst’s intervention involved indirectly suggesting that the patient could obtain information from the public domain (an obituary) connected with an absence of the analyst that was transferentially and countertransferentially laden (her mother’s death). The patient had an inhibition of her curiosity about the analyst, and the information furthered the analysis of paranoid defenses against a positive transference. This inhibition involved a projection onto


the analyst of severe superego interdictions. In her discussion, Reed observed that the unconscious is not permanently altered by external information per se; indeed, the conduct or character of the analyst may summon transference fantasies into activity in a way that makes them diffi cult, if not impossible, to analyze (p. 531). Although a sug-gestion, whether direct or indirect, that may further the analysis could be viewed as a modifi cation of analytic technique that is a departure from neutrality, such an interven-tion ironically also can clarify the analyst’s true neutrality with respect to a confl ict. For Reed’s patient, this was a superego confl ict about looking. Working through in the transference is in itself a means of coming to grips with a reality outside of (or in contrast to) a neurotic psychic reality. Likewise, it is perhaps not uncommon that patient and analyst may share a confl ict about looking at external data that are ‘real’, just as there can be confl ict about the transference–countertransference. Theoretical prohibitions about extra-clinical data may have to do not only with legitimate concern about good analytic technique, but also with an overarching emphasis on fantasy data as a result of Freud’s caveats—compare the notion of ‘reactive reinforcement’ as applied to the theoretically restrictive emphasis on fantasy in the wake of the abandoned seduction theory (Good, 1995, pp. 1162–3).

In another case example (Good, 1994a), the patient’s repetitive dreams, associa-tions, and transference were consistent with her memory of an early genital trauma (clitoridectomy) performed to ‘treat’ masturbatory activity, an approach that has been used in this country. Her memory of this trauma was related to her profound sense of defectiveness, and was convincing. Over time, however, when fi nally asked whether she had ever discussed the problem with her gynecologist, it turned out that she had never raised the subject because of her intense shame and guilt. When these affects were worked through enough so that, following Good’s suggestion, she was able to broach the subject with her gynecologist, she learned that she was anatomically normal, a realization that had a liberating effect on her life, and which led to an intensifi cation of an erotic transference that the false memory had helped to screen.

Discussion and conclusions

The case of Ms A illustrates how false memories and negative affects can be analyzed and understood through a consideration of intra- and extra-clinical data that evolve from—and further—the treatment process. Although she sought out meteorological data on her own, had the idea not occurred to her over an extended period in which she continued to lack conviction about an alternative construction of what happened to her infant, we maintain that it would not necessarily have been technically erroneous to suggest the possible availability of extra-clinical data, as in the cited cases of Reed and Good. There can be times when doubt and lack of conviction about an interpretation or construction are not solely due to resistance, but instead involve intrinsic analytic ambiguities. Indeed, sometimes the analyst’s conviction is countertransferentially based. Of course, external data are not neces-sarily truer than what is intrapsychic. The analyst is analyst, not judge, of what is real. At the same time, the analyst can be open to outside data, certainly not discouraging the analysand from seeking out such information.


At times the analyst’s questions alone may suggest the usefulness of clarifying historical actuality or shedding outside light on a subject, when that is feasible and might promote the analysis. There can be resistances to conducting such an explora-tion into actual past situations that parallel the resistance to talking about certain subjects. Yet the patient’s investigations of biographical material can provide rich opportunity for analysis, provided that it is not undertaken in the service of intellec-tualization and isolation of affect (Novey, 1966; Good, 1994a). What extra-clinical data ultimately mean remains an issue for analysis, since such information does not serve as superordinate truth that bypasses the need for further analysis. We still may not truly know the patient’s full, actual past experience. But to determine, for example, that a signifi cant memory could not have actually happened the way it was remembered communicates a great deal. If we have more than one plausible recon-struction about what the history was, to know subsequently what the history was not tells us even more. Since a goal of psychoanalysis and psychoanalytic therapy is to achieve a different, acceptable, and more accurate view of reality, extra-clinical data may have a role in certain cases.

The following are factors to consider in responding to, suggesting, and possibly even recommending the investigation of available data from outside the treatment setting: (1) pivotal issues about the reality basis of a patients’ psychic reality have been, and appear to continue to be, not likely resolvable by intra-clinical validation alone; (2) extra-clinical information may allow clarifi cation or modifi cation of reconstructive hypotheses already under consideration, add conviction to reconstructive work, and even permit reconstructions not previously entertained; (3) consideration to potentially available extra-clinical data does not appear necessarily or ultimately to represent a resistance to defense analysis, and its inclusion may instead facilitate associations, memories, and recognition of defenses; (4) a patient’s spontaneous research into extra-clinical data may refl ect the achievement of new insight or readiness to consider a reality previously resisted; and (5) in some cases with formidable defenses, questions or forms of suggestion regarding the possible availability of extra-clinical data may outweigh drawbacks to their use, serving as a modifi cation, and thereby further the treatment process. The latter course, as introduced by the analyst or therapist, can be employed cautiously and judiciously in psychoanalysis and psychotherapy.

In general, just as the analyst regards the analytic surface when addressing defenses or making interpretations, a similar principle applies in considering the availability of extra-clinical data that might lead to new and positive clinical developments. It is our impression that, if patients are not ready or willing to make use of carefully posed comments alluding to extra-clinical sources of information that the analyst or therapist thinks might be useful, they are unlikely to do so. Such reluctance or resistance is not to be overcome, but the reasons for it obviously are to be understood. It is not that analysis should routinely focus in any concerted way upon extra-analytic data, but rather that consideration to the possibility of such information not be ruled out prematurely because of undue concern about deviating from the intra-clinical frame. Serendipitous or suggested opportunities to establish correspondences between analytic reconstructions and historical actuality as we can know it may not only benefi t individual analyses, but also may advance the scientifi c basis of the analytic method.


Translations of summary

Falsche Erinnerungen, negative Affekte und psychische Realität: die Bedeutung von außerklinischen Daten in der Psychoanalyse. Als Behandlungsmethode ging die Psychoanalyse aus der Überlegung hervor, dass die Neurose mit der Art und Weise zusammenhängt, wie die individuelle psychische Realität von der Wirklichkeit abweicht. Zur psychischen Realität zählen Erinnerungen, Überzeugungen und die damit assoziierten Affekte und Phantasien, die das subjektive Erleben der inneren und äußeren Welt begleiten. Die psychoanalytische Einschätzung, welche bedeutsamen Erinnerungen oder Überzeugungen unzutreffend, entstellt oder falsch sind, stützt sich für gewöhnlich auf Prinzipien der intra-klinischen Validierung. Eine solche intra-klinische Validierung weist aber ihrerseits Grenzen und Fallgruben auf, die sich allein durch die Überzeugung darüber, was real ist, nicht umgehen lassen. Trotzdem gibt es nur bemerkenswert wenige analytische Fallberichte, die falsche oder signifi kant entstellte Erinnerungen mit Hilfe von Daten nachweisen konnten, die außerhalb des Behandlungszimmers gewonnen wurden. Die geringe Anzahl solcher Berichte könnte zumindest teilweise mit der Annahme zusammenhängen, dass die Verwendung von extra-klinischem Material von Grund auf unanalytisch sei oder dem Widerstand zuarbeite. Gestützt auf die Auffassung, dass (a) die psychische Realität nicht als rein subjektiv oder aber objektiv betrachtet werden kann, sondern dass sie von Natur aus sowohl subjektiv als auch objektiv ist, und dass (b) das Ziel der Analyse darin besteht, zu einer anderen, akzeptablen und in höherem Maße zutreffenden Sicht der Realität zu gelangen, wird in diesem Beitrag eine klinische Behandlung beschrieben, in der eine erwiesenermaßen falsche, aber zentrale Erinnerung und die mit ihr verbundenen negativen Affekte eine wichtige Rolle spielten; diskutiert werden außerdem theoretische und technische Überlegungen in Bezug auf die Verwendung von außerklinischen Daten im Behandlungsprozess.

Falsos recuerdos, afectos negativos y realidad psíquica: el papel de los datos extraclínicos en el psicoanálisis. El psicoanálisis como tratamiento nació de la idea de que la neurosis se relaciona con las maneras en que la realidad psíquica del individuo se aleja de la realidad objetiva. La realidad psíquica incluye recuerdos, creencias, y sus efectos y fantasías asociadas que se conectan con la experiencia del mundo interno y externo de un individuo. La determinación psicoanalítica de qué creencias o recuerdos son inexactos, distorsionados o falsos suele depender de principios de validación intraclínicos. Sin embargo la validación intraclínica está sujeta a limitaciones y defectos que la sola convicción acerca de lo que es real no puede superar. A pesar de ello son signifi cativamente escasos los informes de casos clínicos descritos que muestran recuerdos falsos o signifi cativamente distorsionados por el uso de datos obtenidos fuera del consultorio. Esta parquedad en el número de casos clínicos puede estar relacionada, al menos en parte, con la creencia de que el uso de datos extraclínicos es esencialmente no analítico o alimenta la resistencia. Basándose en consideraciones de que a) la realidad psíquica no puede ser vista como exclusivamente subjetiva u objetiva, sino que es inherentemente ambas cosas y que b) una meta del psicoanálisis es lograr un visión diferente, aceptable y más exacta de la realidad. Se describe un caso clínico que presenta un falso recuerdo (confi rmado como tal) y los afectos negativos que se le asocian, y se discuten las consideraciones teóricas y clínicas sobre el uso de los datos extraclínicos durante el tratamiento analítico.

Faux souvenirs, affects négatifs et réalité psychique : le rôle des données extracliniques en psycha-nalyse. La psychanalyse en tant que traitement trouve ses origines dans l’idée que la névrose est liée aux façons dont la réalité psychique individuelle s’écarte de l’actuel. La réalité psychique comporte des souvenirs, des croyances et leurs affects associés, ainsi que des fantasmes liés à l’expérience individuelle du monde interne et externe. La détermination psychanalytique des souvenirs ou croyances signifi catifs qui sont inexacts, déformés ou faux repose habituellement sur des principes de validation intrapsychique. Toutefois, cette validation intraclinique est en soi sujette à des failles et limitations que seule la conviction sur ce qui est actuel ne peut éviter. Malgré ce fait, il y a remarquablement peu de rapports de cas psychana-lytiques démontrant que des souvenirs sont faux ou signifi cativement déformés, à partir de l’utilisation de données obtenues à l’extérieur du bureau de consultation. Cette pénurie de rapports peut être liée, au moins en partie, à la conviction que l’utilisation de données extracliniques est fondamentalement non analytique ou soutient la résistance. Partant du point de vue que, a) la réalité psychique ne peut être considérée comme exclusivement subjective ou objective mais est les deux à la fois de façon inhérente, et b) le but de l’analyse est d’atteindre une vision de la réalité différente, acceptable et plus exacte, le présent exposé décrit un cas clinique comportant un souvenir central incontestablement faux et ses affects négatifs associés, et discute les considérations théoriques et techniques liées à l’utilisation de données extracliniques au cours du processus du traitement.


Falsi ricordi, affetti negativi e realtà psichica: il ruolo dei dati extraclinici in psicoanalisi. La psicoa-nalisi come cura nasce dall’idea che la nevrosi sia collegata ai modi in cui la realtà psichica si distacca dalla realtà. La realtà psichica comprende i ricordi, le credenze, nonché gli affetti e le fantasie a essi associati, correlati al vissuto dell’individuo del proprio mondo interno ed esterno. In psicoanalisi la determinazione di quali ricordi signifi cativi o credenze siano imprecisi, distorti o falsi poggia sui principi della validazione intraclinica. Tuttavia, tale validazione è soggetta di per sé a limiti e insidie non aggirabili con la semplice convinzione di che cosa è reale. Nonostante ciò, in psicoanalisi esiste un numero eccezionalmente esiguo di relazioni di casi nelle quali si dimostra la falsità o la distorsione signifi cativa dei ricordi avvalendosi dei dati ottenuti al di fuori della stanza di analisi. Questa scarsità potrebbe essere spiegata, almeno in parte, dalla convinzione che l’impiego di dati extraclinici sia essenzialmente non analitico o che esso alimenti la resistenza. Basandosi sull’idea che: a) la realtà psichica non può essere considerata esclusivamente soggettiva od oggettiva, ma è intrinsecamente entrambe le cose e che, b) un obiettivo dell’analisi consiste nell’acquisire una diversa visione della realtà, accettabile e più accurata, nell’articolo si descrive un caso clinico che presenta un falso ricordo (confermabile come tale) estremamente importante e gli affetti negativi a esso associati, e si discutono le considerazioni teoriche e cliniche sull’impiego di dati extraclinici durante il trattamento analitico.

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