A THERAPIST’S FALLIBILISM AND THE HERMENEUTICS OF TRUST

Abstract

Using case material from a three-year psychotherapy treatment, this article illustrates the process undergone by a beginning psychotherapist in integrating a fallibilistic sensibility into his clinical practice. The theoretical concepts of fallibilism, the hermeneutics of trust, and pathological structures of accommodation are briefly reviewed to provide context and support for the development of this clinician’s dedication to fallibilism. Case material then focuses on the historical development of the patient’s pathological structures of accommodation and a critical clinical moment that was transformative for the trajectory of the overall treatment. Through this critical clinical moment, the therapist’s process of becoming more consciously aware of the utility of fallibilism will be illuminated. This fallibilistic sensibility is then integrated more fully into the therapist’s understanding of how this treatment changed both participants. The outcomes of the treatment will be presented, specifically related to the patient’s development of a stronger sense of self and an increased capacity to tolerate and integrate experiences of failure into his subjectivity. Ideas related to the repetitive and selfobject dimensions of the transference will also be briefly considered.

Keywords:

• fallibilism
• hermeneutics of trust
• intersubjectivity
• pathological structures of accommodation
• self psychology

ACKNOWLEDGMENTS

I would like to acknowledge my professor and mentor Peter Buirski for his integral part in helping me develop my understanding of self psychology and intersubjectivity. Without his guidance and teaching I would not have found my professional passion so easily. I will be forever grateful to him for this. Also, I would like to thank Annette Richard, Shelley Doctors, and all my peers that helped throughout the writing process. Finally, I would like to thank my patient, Alex, who has helped me more than he will ever know.

Notes

¹ Throughout this article, I discuss my fallibilistic sensibility in the context of Bernard Brandchaft’s work. I would like to acknowledge, however, that the term itself belongs to Donna Orange (1995, 2011), who speaks of fallibilism in many of her writings.

² Orange (1995) first used the phrase “making sense together” in her writing, which was then chosen by Buirski and Haglund (2001) for the title of their book.

³ I highly recommend the first two chapters of Orange’s book The Suffering Stranger: Hermeneutics for Everyday Clinical Practice for a more in-depth look at the philosophical roots of the hermeneutics of trust.

Additional information

Notes on contributors

JOSHUA R. BURG

Joshua Burg is a graduate of the University of Denver’s Psy.D. program in Colorado and a current postdoctoral fellow at the University of Colorado Boulder. Joshua has interests in pathological structures of accommodation, psychosis, psychological assessment, and using a psychoanalytic approach with chronic mental illness. He is the cofounder of the University of Denver’s Pizza & Psychoanalysis program, which brings local analysts to the university to present case material and psychoanalytic theory. Joshua was an IAPSP Early Career Scholar and currently chairs the Students and Candidates committee. Joshua also maintains a private practice located in Denver, Colorado.