arouse enough anxiety to engage the patient’s seri-
ous contemplation but not so much anxiety that the
patient will reject it. Although therapists have
sometimes been known to make interpretations as
shots in the dark, it is generally wise to be reason-
ably sure of one’s target before firing the salvo.
Being wrong, offering an interpretation too soon,
or providing an interpretation that is beyond what
the patient is ready to accept is likely to be coun-
terproductive. As Colby (1951) put it,“Like push-
ing a playground swing at the height of its arc for
optimum momentum, the best-timed interpreta-
tions are given when the patient, already close to
it himself, requires only a nudge to help him see the
hitherto unseen”(p. 91).
As a general rule, small dosages are best. There-
fore, rather than prepare one grand interpretation
that will subsume all the major aspects of the
patient’s conflicts, it is advisable to approach matters
over a period of time. One can gradually move
from questions to clarifications to interpretations.
This will allow the patient to integrate each step.
In making interpretations, it is important to build
on what the patient has said previously, using the
patient’s own comments and descriptions to build
the interpretive case.
It can be difficult to determine whether a spe-
cific interpretation has been effective. Sometimes
the patient’s response (e.g., a surprised exclamation,
flushing, saying“My God, I never thought of it that
way!”) will suggest that the target has been hit. But
at other times, patients may be entirely noncom-
mittal, only to remark some sessions later how
true the therapist’s comment was. In any event,
the real test of the utility of an interpretation is
more likely to come from the subsequent course
of the sessions. Even a patient’s overt acceptance
can sometimes be nothing more than a way of
diverting the therapist or erecting a defense.
A classic psychoanalytic interpretation is
designed to open up the patient to new ways of
viewing things and, ultimately, to neutralize
unconscious conflicts and defenses. In doing this,
the therapist makes use of free associations, dream
material, behavior that indicates resistance and
transference, and so on. Interpretations can vary aA Case Illustration of Interpretation
This exchange occurred during the 15th session of
psychotherapy with the 27-year-old wife of a college
professor. In previous sessions, she had described how
inadequate their sexual relationship was. In more
recent sessions, she had also begun to discuss how
much she and her husband shared the belief that
theirs was a frank, open, and communicative rela-
tionship. Sometime before the present session, the
patient had taken a 2-day trip to attend a convention
in a neighboring city. On the first day of the conven-
tion, she met a man and promptly went to bed with
him. Afterward, she was several days late with her
period. This convinced her that she was pregnant.
Suspecting that emotional factors might have delayed
her period, her therapist suggested that she hold off
telling her husband until she was sure. She disre-
garded this suggestion and proceeded to tell her
husband everything. The very next day, her period
began.
Patient:Well, I told Dick everything. God, was
I upset.Therapist:Then what happened?
Patient:He took it better than I thought he would. He
was really understanding. Not so much forgiving,
just calm and understanding. And now I’m not
even pregnant. Can you beat that? But I think it
really solidified our relationship and we can go on
from here.
Therapist:Did you expect Dick to be so understanding?
Patient:I’m not sure I knew what to expect. I suppose
I thought he would be upset as hell, but what else
could I do? I know the episode at the convention
was silly. But I just had to find out whether it was
still possible to really enjoy sex.
Therapist:Was it?
Patient:Yes, it really was. Now I know it, and in a way
I feel great.
Therapist:AndnowDickknowsit,andinaway
he doesn’t feel so great. That could well be
the reason you were so eager to tell him
everything.PSYCHOTHERAPY: THE PSYCHODYNAMIC PERSPECTIVE 355