ABSTRACT
As both theory and practice, psychoanalysis contains paradoxes and challenges at its very foundations: uncertainty, indeterminacy, dependence, and loss. First, not-knowing: psychoanalytic self-knowledge and self-understanding must recognize that most of mental life is unconscious. Second, the paradox of self and other: psychoanalysis is our most elaborated theory of individuality, yet the clinical discovery of individual selfhood depends on the other, patient with analyst. Finally, the contingent uncertainty and indeterminacy of development and psychic life challenge narcissism, and the inevitability of loss in life and analysis challenges depression.
Analysts have developed theories and clinical techniques to address these paradoxes. All theories are meant to help patients, yet this chapter suggests that in the classical and contemporary world some theories express more certainty and determinacy than others. The chapter introduces the distinction between “listening to” and “listening for.” Listening to and listening for becomes a clinical divide crossing theoretical difference. Some theories and clinicians portray listening for, whereas other approaches and traditions seem to encourage listening to. Curiosity and uncertainty are requisites for doing clinical work. The chapter concludes with case examples illustrating the challenges of uncertainty and inevitable loss for both clinician and patient. Here curiosity and the concept of ego integrity are helpful.
