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This book is the third in a series that the British Independent psychoanalyst Patrick Casement has written on the nature of the relationship between analyst/therapist and patient. The others Learning from the Patient (Casement 1985) and Further Learning from the Patient (Casement 1990) introduced the idea of the ‘internal supervisor’ as the means by which an analyst or therapist could best judge the degree to which they were working with the patient, or working with their own, incorrect, version of who the patient should be. In this latest book, Casement addresses two distinct but interrelated concerns: the potential dogmatism of the analyst and supervisor, and the need to follow the patient's cues as a guide to the session. He has revised the idea of the internal supervisor, now preferring to think in terms of ‘internal supervision’, a process of monitoring the moment-to-moment state of the analyst and patient in relation to each other and the material in the work.
The book begins with Casement launching an attack on what he sees as an element in psychoanalytic practice that serves to bind the mind of the patient or supervisee to that of the analyst. He suggests that for some people (patients and analysts) the attraction of psychoanalytic work lies in its ability to connect anything to everything else and that this fascination with the structure and workings of the unconscious can put the analyst (or, indeed, supervisor) in the position of a guide or map-reader in a strange land. This position is dangerous, argues Casement, because it is too often based on pre-existing theory rather than the individual patient. The analyst's understanding of how the patient fits the theory can then give rise to a situation where both are caught up in a richly-described world, and each are convinced of its truth. However, a bit like the man who points out that ‘the map is not the territory’, Casement suggests that the patients’ adherence to the analyst's view of them, if it is based