ABSTRACT
A patient's tolerance of the analyst's efforts to think depends in large part on whether the patient can tolerate moments when the analyst disengages from being fully emotionally present so that he can reflect upon the material from a more removed perspective. Patients capable of such thinking tend to be more tolerant of the analyst's efforts to think, more likely to view the analyst's intentions as benign – as meant to be helpful – and better able to engage with the analyst in the task of self-reflection. Patients who lack the capacity for higher-order thinking manifest what Larry Josephs refers to as a "concrete attitude." For these patients, "the concrete is more immediate, compelling, and real than the symbolic the abstract may seem no more than just empty words". While psychopathology has traditionally been viewed as a product of unconscious conflicts and unrecognized mental contents.
