Clinical Seminar Review: Beyond Interpretation – Patrick Casement – Saturday 5th July 2008

On the 5th July, in the midst of our summer that never was, we had some intellectual and psychotherapeutic sunshine, Patrick Casement came to Dublin. More precisely he came to conduct a clinical seminar at Trinity College. So great was the interest among psychologists, psychotherapists, doctors and counsellors that the venue had to be hastily moved from one Trinity theatre in the Hamilton Block to the larger one in the Arts Block.

Patrick Casement had a most interesting and circuitous route to becoming a psychoanalyst.  After leaving Cambridge University where he trained in Anthropology and Theology, he became a probation officer, then a social worker and eventually trained as a psychoanalyst.  Tucked in between this journey was a personal breakdown which resulted in a brief hospitalisation. It was this breakdown which brought him into analysis. He exemplifies Carl G Jung’s belief that, “the best healer was the wounded healer”. One who had worked through most, if not all of his wounds is best equipped to listen, internalize and work through the pain of ‘the other’.

Patrick Casement’s Seminar was divided into a morning and an afternoon session. In the morning session he explained the origins and search for love and the caring that can bear being hated. The therapist who can bear the projections of the transference of hate can expiate the hate and strengthen the patient in his journey towards ‘love’. He also elaborated on the patient who wants to be the “good child” in therapy, and in doing so, gets in the way of finding self.  It also is part of the continuing search for the “good object”, the child who wants to believe her parents are “all good”. Therefore, when the mother treats the child as bad, he/ she wonders if they have lost the good mother. In the example he gave his patient looked from woman to woman to woman, in order to “see love” in her eyes. He made the point that “no matter who you marry, you wake up with someone else” Those of you who are film fans, or are old enough, may remember the uneducated but wise Rita Hayworth. Her most famous film was “Gilda”. After her 3rd or 4th marriage she said wistfully, “All my husbands married Gilda but they woke up with Rita Hayworth”.

The afternoon session was on Internal Supervision which he presented as a detailed account of a session with one particular patient, and included his own thinking as the session developed.  Patrick Casement felt the therapist he was supervising was afraid of bringing her needs into analysis.  Until she could, Patrick Casement could not give what was needed, and the supervisor could not give what her patient needed.  A vicious circle familiar to all of us who practice – Patrick Casement quoted Winnicott’s observation, “that the patient fears a breakdown that may have already happened”.  It was many such remarks by Patrick Casement and his warm regard for his patients that left me with the feeling that Patrick Casement is sometimes trying to fit a Freudian body into a Carl Rogers’ Psyche. His “unconditional regard” for his patients also shines through all of the written work, as in “Learning from the Patient”.  Its title is no accident, and what appears from his Seminar, it is to be the bedrock of Patrick Casement’s clinical philosophy.

I think perhaps the surprise of the day for me, was how much emotion Patrick Casement still was showing about cases re-told more than once in lectures and books.  I was left with a great admiration, but wondered if, professionally, he had worked through many of his counter transference issues.  On reflection, perhaps none of us ever really do.