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Preconception in the Consulting Room: Lecture with Patrick Casement

“If we think about it, and often we don’t, almost everything we take into the consulting room is in the area of preconception. Throughout our training we have been learning to understand the minds of others in terms of what has been understood before. But the more we rely upon the thinking of others the more that may get in the way of our understanding the individual minds of those who come to us for help. I shall therefore focus upon what I regard as the “analytics space”, a space set aside for each patient. And I will focus on those ways in which we can monitor the analytic space, in order to notice how and when we are putting something into this which may not have to do with the patient we are then concerned with.”

 

Patrick Casement is a retired fellow of the British Psychoanalytical Society. He worked as a psychoanalyst for more than forty years, and has written several books and numerous papers on clinical technique. Most prominent among these is On Learning from the Patient, which, since its publication over thirty years ago, has been translated into many languages and used across the world by professionals, both in psychoanalysis and related fields.

From the beginning of his psychoanalytic training, and throughout his subsequent career, Casement was opposed to relying too heavily on particular theories in the consulting room. Instead, his clinical approach was to use whatever made sense with a particular patient in a particular moment; he was not concerned with where a theoretical or technical tool originated – from which thinker or school it emerged – as long as it was useful and true to the work he was doing with that patient. His experience in social work also instilled in him a certain pragmatism, which he retained throughout his analytic career. With regards to the analyst’s role, he returned often to Winnicott’s metaphor of the spatula, which can be shoved down people’s throats, or used playfully, experimentally and expressively. In the same way, he believes that an analyst should not impose theories on a patient, rather that he or she should allow him- or herself to be psychologically explored and played with by the patient.

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