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Doctor, R. Doctor, S. (2004). Learning from our Mistakes: Beyond Dogma in Psychoanalysis and Psychotherapy by Patrick Casement (Brunner-Routledge, London, 2002).. Psychoanal. Psychother., 18(3):346-347.

(2004). Psychoanalytic Psychotherapy, 18(3):346-347

Book Reviews

Learning from our Mistakes: Beyond Dogma in Psychoanalysis and Psychotherapy by Patrick Casement (Brunner-Routledge, London, 2002).

Review by:
Ronald Doctor

Suzette Doctor

Patrick Casement continues his argument from his first two books: On Learning from the Patient (1985) and Further Learning from the Patient (1990), with a new book, Learning from our Mistakes: Beyond Dogma in Psychoanalysis and Psychotherapy. He examines the processes of supervision and internal supervision by which practitioners can develop their awareness of the patient's experience within the clinical encounter, and he particularly considers the issues of mistakes and enactments by the analysts. He argues that psychoanalysis and psychotherapy can be limited by a too-rigid adherence to theory. Therapeutic technique is creative when it is furthering the working alliance between patient and therapist and enhancing patient self-reflection and exploration. Technique too influenced by theory and insufficiently responsive to the patient is in danger of fostering unhealthy compliance or therapist-induced resistance. Of primary importance is that the patient is allowed to discover his own truth rather than that of his analyst.

Casement uses rich and detailed clinical presentations to illustrate how therapists can use patient's conscious and unconscious communications to improve the quality of their interventions. Trial identification with the patient's feelings can lead the therapist to phrase an intervention so that it can be heard and thought about rather than, for example, defended against because of inflicting overwhelming shame. Casement also illustrates how becoming sensitive to the patient's ‘unconscious promptings’ can guide the therapist as to how the patient is experiencing the therapist. Casement's clinical commentaries show an exquisite sensitivity to the patient's experience. One of the ways this is illustrated is through his capacity to stay with not-knowing until the patient's material warrants a comment in tune with his inner world, rather than make a premature interpretation, which might be felt to be an impingement.

The chapter on supervision raises parallel issues regarding conformity (to the supervisor) versus helping the trainee to develop his own voice. This process requires the supervisor, as was the case with the therapist, to monitor his own contribution, if an overly-conforming process develops. The pertinent issue of keeping criticism helpful rather than persecutory was also discussed.


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