On patients’ unique self-knowledge

Patients contribute to analytic endeavors through a knowledge of their own unique ways of organizing their experience, of building an intersubjective space with significant others, of the type of life that they consider worth living, and primarily of their specific passions and yearnings. The more that therapists allow the patients’ unique self-knowledge to influence their therapeutic perceptions and decisions, the further they will advance patients’ status as co-experts working together with the therapist to create and formulate new, richer knowledge. In the present article, it is suggested that one of the main reasons why patients’ self-knowledge is excluded from the therapeutic dialogue is that the persuasive power of the therapists’ rich and deep knowledge challenges the patients’ self-authority. Through an illustrative vignette, therapists are recommended to use a metacommunication intervention to restore the balance that has been undermined between the therapist’s authority and the patient’s self-authority.