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This book is the product of a number of years of reflection by the author on the therapeutic process, on what helps it and what hinders it. In the spirit of Bion's ‘negative capability’ Casement challenges the myth of the analyst as all-knowing, and addresses himself to the task of discovering how and what the patient can teach him. It is a book about technique rather than about theory and is packed with clinical illustrations which enable the reader to join with the author in following and evaluating the give and take between therapist and patient. The material is drawn from Casement's own work with patients, formerly as a social worker and now as a psychoanalyst, and from his work with therapists under his supervision.
But technique needs to be structured by theory, and the theories upon which Casement relics are to do with the complex processes of the unconscious and with the various forms of unconscious interaction between people. The analyst needs to be open to hearing the ‘derivative communication’ behind or beneath the manifest one. The concepts of unconscious sets and of unconscious symmetry, related to primary process thinking, are useful aids in abstracting the important themes from what is being said. Preconceptions and premature judgments, which might give rise to ‘off-the-peg’ interpretations, should be guarded against, so that insight may be allowed to emerge afresh with each patient. Only thus can due value be given to the individuality and creativity of the patient, as well as to the interactional nature of the process.
Seeing analysis as interaction implies that both patient and analyst are active participants. The analyst can no longer pretend to be a blank screen but must recognise elements of objective reality in the patient's perceptions of him, as well as understand the projections made upon him. ‘Trial identification’—putting oneself into the patient's shoes while at the same time remaining in one's own—and ‘internal supervision’ are terms used