‘Laura’ Falling Down: Comments and Fantasies about Jacques André's Essay

… Ce soit avec ma voix propre que s'entende la voix propre de l'autre.

[It is with my own voice that the voice of the other is heard.]

It is she who has become part of me/By my doing: by my knife and hand/I have carved her weight into my heart. /Nor will her image there be moved until he who takes everything apart/Takes me…

Jacques André's essay offers a rich opportunity to consider the way our subjectivity risks getting lost behind the conventions we adhere to when we present clinical material. In the United States, clinical accounts generally offer an illusion of linearity. We present identifying information about the patient, her family history and the onset and development of symptoms in quasi-chronological order. We also apply this linear approach when we describe emerging transferences and interpretations.

On paper, a presentation will look just like a script for a radio play. Brief stage directions even explain the way the patient comes in or out of the office, and dialogue sequences include shorthand for character names: ‘P’ for patient and ‘A’ for analyst, as if the analyst, writing about herself in the third person, can objectively view her own movements. Although the analyst greatly abbreviates and edits the exchange, she presents the dialogue as if it were an exact transcript of the conversation.

Try as we might to make our presentations look ‘real,’ our trompe l'oeil technique also creates problems, most notably that the analyst presents only his conscious view of what passes between her and the patient. David Tuckett (1993) recommends presenting notes of close process to presenters so that listeners and readers may look for openings to unconscious processes outside the analyst's field of vision. Others have departed from linear narratives and included fictional and poetic elements to give a more three-dimensional view of the consulting room's emotional climate. Thus in the haunting essay Hel