Part of what the Psychoanalyst does while listening with freely floating attention to the free associations of his patients is to allow the ripples arising form the depths to nibble at his attention until the vague hints and inchoate clues coalesce into a form that can be put into words. From the undercurrents that animate our patient's words we begin to sense rather than actually see the patterns and structures that inform our patients conscious experience. When such work is disrupted there is often a powerful reason. A brief vignette from early in my career might be helpful:
A very brilliant middle aged woman, stuck in an unsatisfying job and an unsatisfying marriage entered Psychoanalysis for help in understanding her pervasive feelings of inadequacy and unhappiness. On the surface she had all the gifts one might wish for; she was bright, attractive, wealthy enough that work was an option rather than a financial requirement, with interesting friends and a devoted husband. Her history was most significant for what we didn't know rather than any particular trauma. She had grown up in a middle class suburb of Philadelphia, went to an Ivy league school, had a brief failed marriage at a too young age, and had been married for 15 years to a man who cared deeply for her, was an intellectual equal, and appeared to be everything she wanted in a partner.
Early on it became clear that there was something amiss in her treatment. She appeared to adapt to the process easily and naturally. She was able to freely associate in ways that only very few patients seem to ever approximate, yet after several months during which I learned innumerable details about her life, her childhood, and her relationships, I realized that I actually knew very little about how my patient actually experienced the world she was so exhaustively describing. I was quite puzzled by the apparent disconnect between her behavior on the couch and my growing conviction that I was missing the most crucial elements; worse, I had no idea what I might be missing. I cautiously brought this conundrum to her attention. I mentioned that though I thought I now knew a lot about the details of her life, I didn't feel that I knew much about how she experienced her life. What did she feel when these events took place? What did she think about the event she described? It took quite a long time to discover what was going on.