ABSTRACT
If we pay close attention to how our patient sitting opposite us is talking, we begin to realize that she 1 has changed state from thinking and talking symbolically about her feeling state, to suddenly talking about her body or the number of calories contained in food. As practitioners we might think the patient is offering us a concrete symbol to explain a troubling thought, for example, by beginning to talk about how heavy she feels. But if we try to shift the conversation to the symbolic emotional realm-perhaps we might begin to talk about how heavy hearted she might feel-we find that the patient steadfastly refuses (or is unable) to follow us and instead continues to talk about her weight.
