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(Received 3 October 2023; accepted 17 February 2024)
Patrick Casement, renowned psychoanalyst, was recently encouraged by Dr Kelly Jayne, to write a paragraph describing his approach to clinical work. ‘Learning from the patient in retrospect’ was published in the Bulletin of the British Psychoanalytical Society June 2023 (vol 59 no 5) page 31. As the Bulletin is confidential, and only for members of the British Psychoanalytical Society, we are pleased to share it to a wider audience here, with kind permission of the author and publisher.
‘Now approaching 88, I had thought I would be immune to further temptations to write. But I was mistaken. When asked to describe my approach to clinical work “in just one paragraph”, how could I resist such a challenge? So, here goes.
While listening to a patient, there are some questions which I am putting to myself. What might the patient most need me to hear in what they are communicating to me at this moment, whether in word or silence, or in the quality of their presence? What can I say that could open up some exploring of this? What might I then be contributing to the analytic space and process? Could this then lead to creative playfulness or might it just lead to some confrontation or compliance? Am I merely applying insight from preconception or am I opening up a joint exploring towards some fresh understanding, which could be arrived at along with the patient? Am I trying to analyse from some position of assumed understanding, or am I truly open to arriving at some insight along with the patient? Am I actually open to learning with my patient at this moment or am I slipping back into trying to interpret from theory and from other experience?’
The paragraph was warmly received, with many colleagues sharing generous feedback some of which we include below.