On Learning from the Patient is concerned with the potential for psychoanalytic thinking to become self-perpetuating. Patrick Casement explores afresh the dynamics of the helping relationship - learning to recognize how patients offer cues to the therapeutic experience that they are unconsciously in search of. Using many telling clinical examples, he illustrates how, through trial identification, he has learned to monitor the implications of his own contributions to a session from the viewpoint of the patient. He thus shows how, with the aid of this internal supervision, many initial failures to respond appropriately can be remedied and even used to the benefit of the therapeutic work. By learning to distinguish better what helps the therapeutic process from what hinders it, ways are discovered whereby the circularity of pre-conception can more effectively be avoided by those who aim to understand the unconscious of others. From this lively examination of key clinical issues, the author comes to see psychoanalytic therapy as a process of re-discovering theory - and developing a technique that is more specifically related to the individual patient. The dynamics illustrated here, particularly the processes of interactive communication and containment, occur in any helping relationship and are applicable throughout the caring professions. Patrick Casement's unusually frank presentation of his own work, aided by his lucid and non-technical language, allows wide scope for readers to form their own ideas about the approach to technique he describes. This book, together with its sequel Further Learning from the Patient, will be invaluable to trainee and practising analysts or therapists, and those teaching in related professions.

Table of Contents

Acknowledgements. Williams, Foreword. Introduction. Preliminary Thoughts on Learning from the Patient. The Internal Supervisor. Internal Supervision: A Lapse and Recovery. Forms of Interactive Communication. Listening from an Interactional Viewpoint: A Clinical Presentation. Key Dynamics of Containment. Analytic Holding Under Pressure. Processes of Search and Discovery in the Therapeutic Experience. The Search for Space: An Issue of Boundaries. Theory Re-discovered. Appendix I: Knowing and Not-knowing: Winnicott and Bion. Appendix II: The Issues of Confidentiality and of Exposure by the Therapist. References. Name Index. Subject Index.