Blum HP : The value of reconstruction in adult psychoanalysis.

Reconstruction is clinically valuable for the patient and fundamental for the analyst. The analyst will inevitably use reconstruction in order to comprehend the patient and to understand how that adult has remained a disturbed child with that particular psychopathology. Although not necessarily specified, reconstruction remains a very important dimension of psychoanalytic technique that is regaining analytic attention. After reviewing reasons for the shift of attention away from reconstruction, the signifcance of reconstruction is emphasized for restoring personality continuity and cohesion and for explaining neurotic repetition as it has developed in life and in the analytic transference. This utilization of reconstruction is illustrated in a case of anniversary depression, demonstrating the linkage between historical events and their intrapsychic interpretation and response, as well as the linkage between past and present, childhood and adult disorder. Reconstruction does not always automatically follow from the transference and analytic work. It is an inferential and integrative act which may overcome resistance and amnesia, which synthesizes memories and genetic interpretations in addition to substituting for missing memory and gaps in history. Without reconstruction, the personal and familial myths of the past may be joined by current analytic myth. The reconstructive integration identifies patterns and interrelationships rather than isolated conflicts and experiences, and the intrapsychic configurations, consequences, and developmental influences are far more important than actual historical facts. The past is transformed to new meanings and reorganized on new levels of development. Reconstruction leads to consideration and investigation of the mental processes of childhood and early infancy. It has had a significant role in the development of psychoanalysis, and reconstruction contributes to the formation, testing, and validation of psychoanalytic theory. For clinical research, it will be particularly rewarding to reconstruct the different phases of the psychoanalytic process.