Anne Alvarez is presenting today at IPI at the conference called The Thinking Heart (the same name as the title of her excellent book). Anne described three levels of therapeutic response — 1) explanatory, 2) descriptive, and 3) intensifying and vitalizing — depending on the state of mind of the patient. At the explanatory level the analyst makes an interpretation about what the patient is projecting into the analyst and why he needs to. At the descriptive level she describes what the patient feels and does not address why. Both these approaches involve addressing the patient directly as “you” but in some states of mind the patient experiences a “you” comment as persecutory. At the intensifying and vitalizing level, she simply says to the patient “it” is upsetting, acknowledging and sharing the experience without intrusion and without insisting on “you” and “I”.