Radical psychoanalytic approaches

‘What is the underlying principle governing psychoanalysis and psychoanalytic therapy more generally?’ asks Neville Symington in the foreword. Author Patrick Casement answers, ‘We may often be interpreting for our own reasons, seeking to demonstrate our own competence rather than staying longer with a more honest sense of not knowing, until our understanding might later emerge’. 

After ending his clinical practice with patients when he turned seventy, Casement brought his writings on psychoanalytic practice, that had been scattered between various journals and his own archive, together in this book. His writing covers observations on internal supervision, trial identification with patients, and how analytic space is either preserved or spoiled by the analyst’s contributions. Throughout, Casement cautions against preconceptions that steer the analytic process along familiar lines. Instead he advocates a more radical approach that is open to being led by the process emerging between analyst and patient.

In his own therapy, Casement tried to be open to the aim and goal of the patient, realising that this may be quite different from his own attitude to life. A fault often seen in clinical work is the moulding of the individual into the scheme of a generalised system. One of Casement’s major messages is that it is an absolute error to attempt to squeeze the patient's outlook into a system of thinking cherished by the clinician’s professional outlook. Casement also argues that eventually a therapist has to find authentic ways of working, being true to oneself, rather than simply accepting ways of working learnt from others.

This essential aid to practicing psychoanalysts and psychotherapists is recommended to colleagues within social sciences and psychoanalysis but also those who are interested in understanding fellow human beings. The book makes a natural pair with Casement’s first book ‘On Learning from the Patient’, published in 1985.

Reviewed by Dr. Giovanni Timmermans
Clinical psychologist working in healthcare in the Netherlands