{"title":"“联名问题”:患者对显而易见的问题的询问。","authors":"Behdad Bozorgnia","doi":"10.1057/s11231-025-09492-y","DOIUrl":null,"url":null,"abstract":"<p><p>Patients often ask questions to which they already know the answer. Despite their ubiquity, little is written about understanding or handling them. The following paper uses Speech Act Theory and the concept of \"cosigning\" to present a theoretical understanding of patients' questions about the obvious along with three clinical vignettes to demonstrate their technical management. The unconscious intent behind such questions can be inferred by analyzing their effects on the analytic process, the analyst's moment-to-moment countertransference, and the pressure they exert on the analytic relationship. The optimal response to cosigning questions depends on the particular dynamics which necessitate their use. For patients who can mentalize their behavior, direct interpretation or observation followed by interpretation can be used. For patients whose mentalization capacity is limited, consciously playing along with the questions can serve as a preamble to offering interpretations of the motives behind them.</p>","PeriodicalId":52458,"journal":{"name":"American Journal of Psychoanalysis","volume":" ","pages":"81-94"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"'Cosigning questions': patients' inquiries about the obvious.\",\"authors\":\"Behdad Bozorgnia\",\"doi\":\"10.1057/s11231-025-09492-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Patients often ask questions to which they already know the answer. Despite their ubiquity, little is written about understanding or handling them. The following paper uses Speech Act Theory and the concept of \\\"cosigning\\\" to present a theoretical understanding of patients' questions about the obvious along with three clinical vignettes to demonstrate their technical management. The unconscious intent behind such questions can be inferred by analyzing their effects on the analytic process, the analyst's moment-to-moment countertransference, and the pressure they exert on the analytic relationship. The optimal response to cosigning questions depends on the particular dynamics which necessitate their use. For patients who can mentalize their behavior, direct interpretation or observation followed by interpretation can be used. For patients whose mentalization capacity is limited, consciously playing along with the questions can serve as a preamble to offering interpretations of the motives behind them.</p>\",\"PeriodicalId\":52458,\"journal\":{\"name\":\"American Journal of Psychoanalysis\",\"volume\":\" \",\"pages\":\"81-94\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Psychoanalysis\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1057/s11231-025-09492-y\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Psychology\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Psychoanalysis","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1057/s11231-025-09492-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Psychology","Score":null,"Total":0}
'Cosigning questions': patients' inquiries about the obvious.
Patients often ask questions to which they already know the answer. Despite their ubiquity, little is written about understanding or handling them. The following paper uses Speech Act Theory and the concept of "cosigning" to present a theoretical understanding of patients' questions about the obvious along with three clinical vignettes to demonstrate their technical management. The unconscious intent behind such questions can be inferred by analyzing their effects on the analytic process, the analyst's moment-to-moment countertransference, and the pressure they exert on the analytic relationship. The optimal response to cosigning questions depends on the particular dynamics which necessitate their use. For patients who can mentalize their behavior, direct interpretation or observation followed by interpretation can be used. For patients whose mentalization capacity is limited, consciously playing along with the questions can serve as a preamble to offering interpretations of the motives behind them.
期刊介绍:
The American Journal of Psychoanalysis is an international psychoanalytic quarterly founded in 1941 by Karen Horney. The journal''s purpose is to be an international forum for communicating a broad range of contemporary theoretical, clinical, professional and cultural concepts of psychoanalysis and for presenting related investigations in allied fields. It is a fully peer-reviewed journal, which welcomes psychoanalytic papers from all schools of thought that address the interests and concerns of scholars and practitioners of psychoanalysis and contribute meaningfully to the understanding of human experience. The journal publishes original papers, special issues devoted to a single topic, book reviews, film reviews, reports on the activities of the Karen Horney Psychoanalytic Center, and comments.