In this paper, the authors develop a model of psychoanalytic clinical reasoning as the inferential process by which analytic therapists are able to arrive at an understanding of the clinical material. Starting from Bion’s theory of functions, the authors propose that a “function” can be thought of as a condition-action sequence that analytic therapists implicitly use to respond to certain configurations of elements in the material by executing conceptual or reflective operations. To investigate the main families of functions that are used by analytic therapists in everyday practice, the authors used an interpersonal process recall procedure based on supervision sessions from a theoretically heterogeneous group of participants. A consensual procedure was developed to identify operations, spell out the underlying functions, and group functions into families. Twelve families of functions were identified that appear to be used by analytic therapists regardless of their schools of thought. The authors call them the “operators” of psychoanalytic clinical reasoning. According to the operators model, the process of psychoanalytic clinical reasoning consists in the chaining together of operations using functions from different families. A specific collection of “clinical reasoning styles” seems to be interwoven in this process. Different avenues open up for research, clinical practice, and training.

中文翻译：

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精神分析临床推理的算子模型


在本文中，作者开发了一种精神分析临床推理模型，作为分析治疗师能够理解临床材料的推理过程。从比昂的功能理论出发，作者提出“功能”可以被认为是一种条件-动作序列，分析治疗师通过执行概念或反思操作隐式地使用它来响应材料中元素的某些配置。为了调查分析治疗师在日常实践中使用的主要功能系列，作者使用了基于理论上异质参与者组的监督会议的人际过程回忆程序。制定了一个一致同意的程序来识别操作，阐明基本功能，并将功能分组到系列中。分析治疗师似乎使用了十二个函数家族，无论他们的思想流派如何。作者称他们为精神分析临床推理的“操作者”。根据算子模型，精神分析临床推理的过程在于使用不同系列的函数将操作链接在一起。一系列特定的“临床推理风格”似乎交织在这个过程中。研究、临床实践和培训开辟了不同的途径。