I've been a writing teacher for decades, but only for the past 9 or 10 years have I taught about psychoanalytic case writing. Before I returned to graduate school and became an analyst, I was a middle school English teacher. I learned a lot from those young students, 11- and 12-year-olds, about what works in teaching writing.
The children taught me to respect that they had thoughts and imagination, that they could take interest in and even enjoy writing. I learned not to over-direct, but rather to let them discover. My chief expectation (perhaps) was that they be active. From experience, I learned to be patient with discomfort, silliness, irreverence—to calmly wait it out. I'm sure you hear the parallel to what we analysts strive to do, as we listen in the treatment room. Writing, like speaking, is a vital way of thinking.
Maybe second in importance, I gave these children things to read: models that could engage and excite. For example, we read old English ballads—those brief, vivid, passionate, often violent story poems. The children loved them, recited them, memorized them, made skits based on them, all activities that offered a better chance they'd enjoy writing their own ballads.
In one assignment, I asked the students to choose a favorite ballad and turn it into a brief newspaper story—a form familiar to them. The headlines they came up with alone were priceless. Next they had to do the reverse: Find a newspaper story and turn it into a ballad. Take one thing, make it into another, aware of the different form. That's a version of the task in writing about our patients.
I also learned not to tell my students how a poem was put together but rather to ask them what they noticed and, if the poem worked, why it worked. They'll observe it, find the form, then tell you how it works: the stanza is made like this, there's this many syllables in the lines, the rhyme goes like that, some words repeat, the details have zip —there's no polysyllabic descriptive jargon! And the story? The story is great: somebody gets murdered, there's love, hatred, vengeance, retribution; a young lady has a baby, she isn't married; a ship sinks, a hero dies, and so on.
Writing about clinical work is similar, and so is the task (you can make the connections). The ballad or newspaper headline or clinical exchange tells a story, and the writer's job is to find the form to tell that story. What do you notice? What happened? How did it happen? What was the action? What words, what forms for words (poem, newspaper story, play script) might help you think about it?
Let me offer three principles I try to hold in mind, whether as teacher or a writer myself. First, writing is hard work. It's a form of thinking, and the most effective thinking, as it penetrates to our feelings, will include discomfort. Second, the most important things about writing are the same for all writing. The problem most of us face in writing isn't simply a matter of technique, or the particular form; it's about awareness, focus, interest—a matter of noticing, whether you're writing a poem, an essay or a clinical vignette describing analytic process.
Finally, I believe that writing is a process of mourning and entails loss. This third idea especially helps me when I'm struggling. Writing about one's clinical work too involves loss—in Freud's language, “working through.” I'll return to the ballad analogy: One is telling a story. What is a story? An experience re-incarnated, in a new form. On these terms, all writing, all “true” writing, is a form of working through, grieving for the loss of the actual immediate complete experience itself. That's why it's hard. When writing about one's clinical work—telling the story of an intimacy over time with a suffering striving person—one is reconnecting as well as saying good-bye, separating oneself out as well as rejoining. It is a pleasure. By finding a form that acknowledges a beginning and an end, a relationship can be both restored and let go: One is affirming a bond and at the same freeing oneself and the patient.
In the satisfaction of writing this piece, I am remembering and saying good-bye, grieving the loss of my students and my patients while also refinding them.
Ellen Pinsky, PsyD, a psychoanalyst in Boston, is the author of Death and Fallibility in the Psychoanalytic Encounter: Mortal Gifts (Routledge, 2017)