What is a clinical fact?

Int J Psychoanal. 1994 Dec:75 ( Pt 5-6):939-47.


As a preliminary to the question, 'What is a clinical fact?', the author asks the wider question, 'What is a fact?', answering that facts are double in aspect: they both say how the world is, and they also depend on our species, our language, theory, etc. A claim of fact in any empirical discipline--in the natural sciences or in human studies with their different methods--is a truth claim which is not infallible or unique to the fact, and also a claim that must offer itself for verification. Using the clinical record of three sessions, she then tries to answer the question, 'What is a clinical fact?', offering the starting formulation that clinical facts, under the unusual conditions of an analytic hour which give an analyst access to a patient's inner world, manifests themselves in the form of immediate psychological realities between patient and analyst. On the way, the author discusses the analyst's anxieties about making a claim of clinical fact; further striking features emerge about clinical facts in the three sessions, and some unsolved problems, i.e. the variety of analytic theories, subjectivity and objectivity, are noted. Even while they bear the perplexities of their problems, clinical facts are of great significance to the study of the mind. They extend the domain of psychology to the area of the mind's interiority, with its human experiences of subjective meaning, conscious, and especially unconscious.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Communication*
  • Defense Mechanisms
  • Humans
  • Male
  • Object Attachment
  • Physician-Patient Relations
  • Problem Solving
  • Psychoanalytic Interpretation
  • Psychoanalytic Theory
  • Psychoanalytic Therapy*
  • Reality Testing
  • Unconscious, Psychology