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Patrick Casement has combined two previously published volumes into a text on technique that is intended for the therapist in training but that will be welcomed by the most experienced practitioner
as well. It is an easily accessible work, relatively free from technical jargon and built around dozens of clinical vignettes. Beyond its value as a teaching aid, it provides clinical data that give readers the chance to judge the merits of the author's view of what is happening in the consulting room. The emphasis on what actually goes on in treatment and the author's openness to scrutiny are the strengths of this entertaining and informative work.
The first half of the book was previously published in England as On Learning from the Patient ; the second half originally appeared as Further Learning from the Patient . It is not the author's purpose to make a novel theoretical contribution; rather, Casement tries to present the practical application of concepts that, for the most part, he attributes to others, especially Winnicott, Bion, and Langs. (Wallerstein points out in the foreword that he has an unacknowledged debt to Gill as well.) The thrust of the work, as the title suggests, is to help analysts learn from their patients how to help, rather than impose their own ideas dogmatically. His view is that patients have an “unconscious hope” (chapter 17) that pushes them to try to get what they need, rather than want, from their therapists. Part I, titled “First Principles,” is more of a manual of technique; Part II, called “The Analytic Space and Process,” provides more theoretical elaboration, although still based on rich clinical illustration.
In many of his examples, particularly in the first part of the book, Casement demonstrates the analyst's mind at work. He has a fine sense of the pushes and pulls to which the analyst is subjected and of the subtle enactments that take place between analyst and patient. His technical recommendations, if not subtle, are valuable,