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Psychotherapy

Review of "Learning from Our Mistakes"

By Patrick Casement
Guilford Press, 2002
Review by Petar Jevremovic on Apr 12th 2004
Learning from Our Mistakes

Patrick Casement is prominent British psychoanalyst and psychotherapist. Before this recent book, he had published two more books: On Learning from the patient and Further learning from the patient.

My thesis is that the potential of psychoanalysis is paradoxical. It can either free mind or bind it. These two simple sentences, written by Casement himself, could be the best introduction to his recent book. Being psychoanalyst, or even being psychotherapist, is far from being self-understanding. The theoretical knowledge is not enough. Even pure technique is not enough. Being psychoanalyst (or being psychotherapist) necessary implies a special kind of (critical) self-consciousness. You simply cannot deal with somebody other's (split or repressed) unconscious parts of personality if you are not able somehow to apprehend uncertainties in your own unconsciousness.

Being an analyst, you cannot escape from being human. It is impossible to think about the transference without serious considering of the countertransference. If not, therapeutic process itself could be (more or less) potentially harmful for both sides, for the patient and (even) for the therapist himself. I have heard it said by some senior analysts that 'the analyst should never admit to a mistake' Why not?

These are Casement's words: ...there is one thing that psychoanalysis appears to do almost best of all: it can turn ordinary people into something extra-ordinary. It can turn them into psychoanalysts. And there is problem. For, it does not always follow that psychoanalysis (at last within a training context) necessary releases people to develop their own minds and thinking. There is a great danger for psychoanalysis in becoming entrapped in some kind of ideology. Ideological discourse is one of the worst enemies of the modern psychoanalysis. The question of training and of education of the further analysts is something that is rather delicate.

Psychoanalysis today is highly institutionalized and symbolically determined. It has its own rituals of initiation, traditions and routines. Being a psychoanalyst implies being trained as a psychoanalyst. Any reasonable psychoanalytic training presupposes some order of values, some (we could say) ideals. The question of transmission of these ideals is (in the same time) the question of the future of psychoanalysis. Because of that we must be really careful. This could be one of the basic messages of Casement's book. There are some serious deviations in our actual training practices. There is too much ideology in psychoanalytic institutes. There is too much (false) certainty in their curriculums. There is too much false-selfs in psychoanalytic candidates and their teachers. Why? There is a serious problem in the core of the idea of psychoanalytic institution.

Casement is rather brave and open critic of this (always potentially harmful) sterility of institutionalized psychoanalysis.  When students in psychoanalytic training are caught in a system of too much sureness, it can become extremely difficult for them to remain authentic. Psychoanalytic trainers frequently function as the priesthood of the institute to which they belong. And the priestly function, traditionally, had been to uphold status quo and to keep it pure from whatever may threaten to dilute or undermine it. So, it is not unusual for trainers to teach from a position that can become dogmatic: sometimes with a degree of sureness that can begin to sound like certainty. Although psychoanalysis does have the potential for providing an opportunity for creative change, and fresh aliveness, it has also continued to develop the non-creative (even non-analytic) practice of using pressure: in particular the pressures of authority. One possible result of these pressures could be that some training analyses can only bring about false-self change in the student. And nothing else...

Psychoanalytic practitioners sometimes slip into a position of arrogance, that of thinking they know best. Thus, when something goes wrong in an analysis, it is often the patient who is held accountable for this, the analyst assuming it to be an expression of the patient's pathology rather then perhaps (or least partly) due to some fault of the analyst's. It is unfortunate that analysts can always defend themselves by claiming special knowledge of the ways of the unconsciousness. But analysts can become blind to their own mistakes. And even more importantly, they can fail to recognize when it is sometimes the style of their clinical work itself that may have become a problem for the patient.

These are serious words. The analyst could be arrogant. The arrogance ot the analyst could be harmful for his patient. Being analyst doesn't mean being perfect. We all make mistakes. Casement's message is clear: possibility for making mistakes as always present in the transference situation. Analytic insight is usually a complicated mixture... We therefore often interpret in terms of part-truths, to be explored between patient and analyst, rather than make statements about the patient that can sound as if we see them as timelessly true. There is always some contingency in the analytic situation.  The most important thing here is not that we should make no mistakes (an impossibility) but that we remain sufficiently thoughtful about the issues in question, both before and after the event. Speaking in the terms of Casement's book: there are two kinds of countertransference. One is called diagnostic and other personal. Diagnostic countertransference could give us useful clues about the patient and our responses to patient. Personal countertransference has to do with our own internal world and sensitivities.

This book will be of great interest for beginners and for mature and highly experienced analyst. Its value is (or it could be) practical and theoretical. The main importance of this book, I believe, lays in its author's courage to see things from rather different perspectives. It is not necessary to agree with him in all of his ideas and to accept all of his theses. On the contrary, priority is on questions not on answers. And the questions that are posed here represents the best richness of this book.

 

 

© 2004 Petar Jevremovic

 

Petar Jevremovic: Clinical psychologist and practicing psychotherapist, author of two books (Psychoanalysis and Ontology, Lacan and Psychoanalysis), translator of Aristotle and Maximus the Confessor, editor of the Serbian editions of selected works of Heintz Kohut, Jacques Lacan and Melanie Klein, author of various texts that are concerned with psychoanalysis, philosophy, literature and theology. He lives in Belgrade, Yugoslavia.

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