The International Journal of Int J Psychoanal (2013) 94:1129–1134
doi: 10.1111/1745-8315.12131
Psychoanalytic Controversy Introduction: What does the presentation of case material tell us about what actually happened in an analysis and how does it do this? Rachel B. Blass Heythrop College, 23 Kensington Square, London W8 5HN, UK – [email protected]
The present controversy brings together different perspectives on the nature and value of analytic case material. This topic was chosen in order to invite reflection on what appear to be differences between analysts, as well as analytic schools and cultures regarding how clinical material ought to be presented and what it is intended for. Should the material strive to present an accurate description of the analytic encounter? What does accurate mean in a context in which our emotional reactions and ways of listening are integral to the encounter? And given the biases and limitations, theoretical and personal, which influence our experience of events, our recall of them and how we choose to present them, is it ever possible to provide a somewhat objective account of what happened? What then can clinical material demonstrate, illustrate, or tell us about the analytic encounter and what can be inferred from it? These questions rest in part on how we consider the aims of analysis and the kind of understanding or truths it provides. Of special interest in this context is what is thought to be the unique position of some schools of French psychoanalysis on the presentation of case material. Most psychoanalytic schools tend to stress the importance of hearing portions of verbatim of analytic sessions (usually based on process notes written up after the session). The verbatim is commonly regarded as a kind of ‘raw material’ that in some way gives listeners or readers less contaminated access to what went on in the analytic encounter. While perhaps not free of selection bias, it is thought to provide data that potentially can be understood differently from how the presenting analyst himself may have understood it. It thus provides the reader or listener with the opportunity to assess the value or validity of what the analyst claims about the encounter and what he learned from it. In contrast, in some French psychoanalytic circles detailed verbatim accounts of the sessions seem to be regarded as secondary or even unhelpful. There are psychoanalysts who offer instead a range of reflections on their patients, associations, often couched in theoretical terms. This approach to the presentation of clinical material is not well understood by non-French analysts and mutual lack of understanding on Copyright © 2013 Institute of Psychoanalysis Published by John Wiley & Sons Ltd, 9600 Garsington Road, Oxford, OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA on behalf of the Institute of Psychoanalysis
1130
R. B. Blass
this issue is perhaps a stumbling block to efforts at dialogue between analytic cultures. Two years ago Dominique Scarfone, then editor of ‘The Analyst at Work’ section of the IJP, addressed this issue when one of the cases submitted for that section by a French analyst was so filled with theoretical formulations that Scarfone feared that it would be seen as an inappropriate presentation of clinical work. In his extended introduction to the section, Scarfone argued that what characterizes a good case presentation is that it brings to life the analyst’s struggle to understand the patient and the analytic encounter and how the struggle was resolved. It should, he wrote, provide “a ‘live wire’ connecting the reader to something still asking to be heard and eventually re-elaborated, even reinterpreted” (Scarfone, 2011, p. 756). This, he suggests, may take many forms, including theoretical deliberations on a patient. In his view, what is most important, whether the presentation is theoretically oriented or includes verbatim (data which, he maintains, cannot and should not be regarded as “raw”) is to avoid demonstrations or illustrations which bind the listener or reader to the analyst’s interpretation or way of thinking. It may be seen that this emphasis on conveying the live struggle to understand emerges from a certain epistemological stance. This is the stance that our theories and personal involvement so shape the clinical material and how we see and understand the consequences of our interpretations that any effort to directly prove a point, demonstrate the value of a hypothesis, will not be very convincing. Conviction arises from being allowed to share in the analyst’s thought processes when faced with the unknown. This approach to presentation of clinical material and the epistemological position on which it rests are clearly open to debate. The contributions to the present controversy enter into this debate and more broadly open the issue of presentation of clinical material to further reflection. Participating in this controversy are Dr Dale Boesky, Dr Elias Rocha Barros and Dr Catherine Chabert. Dale Boesky is a Training and Supervising Analyst of the Michigan Psychoanalytic Institute and is a past Editor-in-Chief of The Psychoanalytic Quarterly. Elias Rocha Barros is a Training Analyst and Supervisor of the S~ao Paulo Society and also a Fellow of the British Psychoanalytical Association where he underwent his psychoanalytic training. He was past Editor for Latin America of the IJP. Catherine Chabert is a Training Analyst at the Association Psychanalytique de France (APF) and is a professor of Psychopathology at Paris-Descartes University. She is co-director of the review Libres Cahiers pour la Psychanalyse. By bringing together analysts from different regions and from different analytic cultures—including ego psychological, Kleinian, and French approaches—who have extensive experience in presenting case material and a concern with issues of how to present it, we hoped to be able to explore differences within the analytic community on these issues. To help promote dialogue with a French perspective we first procured papers from Drs Boesky and Rocha Barros. They were asked to address the topic of ‘What does the presentation of case material tell us about what actually happened in an analysis and how does it do this?’ This request was accompanied by Int J Psychoanal (2013) 94
Copyright © 2013 Institute of Psychoanalysis
Psychoanalytic Controversy: Presenting case material
1131
elaboration of some of the questions that may arise in this context. Dr Chabert was then asked to reflect on these papers and offer her own stance. Finally, Drs Boesky and Rocha Barros were given the opportunity to respond, an opportunity which Dr Boesky made use of. The three main papers that emerged offer different perspectives but seem surprisingly compatible, with the differences being mainly matters of emphasis: Dale Boesky speaks of the importance of contextualization. This is the process of applying organizing principles that shape how we regard clinical material and make only certain psychic structures come to the fore (just as the pathologist’s application of a certain dye determines the structures that can become visible). Boesky emphasizes that in case presentations information should be provided regarding this process. We should explain why certain groups of associations or events, certain contextual horizons, are given priority in the determining interpretations offered. According to Boesky this is rarely practised. He writes: Instead of informing us about the contextualizing information by which we determine meaning and interpretations, we tend to rely on a fallacious assumption when we ‘validate’ an interpretation only on the basis of the reactions of the patient immediately after the interpretation. (Boesky, 2013a, p. 1138)
Readers may consider whether this depiction of common practice corresponds to their own experience. Perhaps its validity depends on the extent to which the process of determining meaning must be clarified according to Boesky. While many analysts (like Scarfone) would contend that in presenting clinical material they regularly consider alternative interpretations and try to describe contextual factors that impact their choice of interpretation, I think that many would also maintain that they do so within certain limits, e.g. the limits of one’s school of thought. Many analysts would hold that broader consideration of alternative interpretations is needed only in the situation of debate between schools. Similarly, one may question the extent to which contextual horizons can or should be made consciously present; whether having implicit contextual horizons is not integral to understanding clinical material and its presentation in a live and vivid way. It will be noted that Boesky’s focus is on interpretations per se. That is, what need to be explained are the grounds of interpretations, how they are inferred, and the role of contextualization in the inference process. In this context, he considers process notes to be an especially valuable source of information. A major concern of Rocha Barros’s paper is how one can in the context of a case presentation convey the live experience of the analytic encounter. This is a problem, he explains, because of the distance (physical and temporal) of the listener/reader from the actual occurrence of the experience and the fact that experience is not something that can be fully captured by words. Rocha Barros’s solution is “to use a style that evokes expressively a similar experience” (2013, p. 1146). This, he argues, entails restoring the meaning of the experiences. Rocha Barros also stresses that in evoking Copyright © 2013 Institute of Psychoanalysis
Int J Psychoanal (2013) 94
1132
R. B. Blass
experience the analyst should take care not to force the experience on the reader/listener but rather leave space for his projections and the expression of his own views. It is this space that allows for critical examination of the analyst’s way of thinking. Discussion of the question of how this takes place occupies a good part of the paper, with Rocha Barros elaborating the kind of poetic skills that are required of the analyst for this. He also, however, refers to a tension between the analyst’s wish to share the analytic encounter in a way that invites reflection and the fact that he needs to and should selectively present material in order to convincingly illustrate his point. (It would seem that Rocha Barros differs with Scarfone on this necessity.) One should note that while Rocha Barros emphasizes experience he is also concerned with the validity of the meanings, theories and concepts which are manifested in the experiences or inferred from them. But the reader will note that his stance in regard to validity differs in several ways from that of Boesky. Dr Chabert opens her discussion of the papers of Boesky and Rocha Barros with an exposition of what she regards as essential to Freud’s theoretical models. This theoretical emphasis (which may be surprising to some readers) emerges as integral to her thinking about the presentation of case material. It highlights the context of interpretation that she considers relevant to an analytic case presentation and also explains the latent forces in the analyst that work against the overt aim of presenting in a meaningful and communicative way. According to Chabert, not only are there inherent obstacles to presenting what happened in an analysis (of the kind that Rocha Barros emphasizes) but also dynamic forces—e.g. we wish to guard the intimacy of the analytic encounter and experience its presentation as an act of betrayal (Chabert, 2013, p. 1153). Like our patients we wish, in part, to avoid the change that comes with communication; and our narcissistic needs drive us to communicate in a way that produces approval of our work. Chabert maintains that Boesky and Rocha Barros, in their accounts of how to present an analytic case, capture very different, although not necessarily opposed, aspects of how we relate to the analytic situation. The one focuses on our efforts to objectively assess our understanding and the other on the efforts to subjectively convey our experience. While Chabert thinks that there is value to both approaches, she also thinks that each has limitations. She maintains that Boesky is striving for an unattainable certainty, a correct or true interpretation, which he hopes to demonstrate through contexualization and through presenting the raw data of the verbatim. But this, Chabert argues, does not adequately take into account subjective influences, including those that impact on the presentation of the verbatim. In contrast, Rocha Barros, according to Chabert, is too subjective. Analysis refers to a reality, not a fiction, experience cannot be separated from theory, and our theories and concepts need to be put to the test in the course of case presentations. Therefore, Chabert concludes, poetics is not enough to present what went on in the analytic situation. In this context, the reader of this controversy will be invited to assess the critiques and Int J Psychoanal (2013) 94
Copyright © 2013 Institute of Psychoanalysis
Psychoanalytic Controversy: Presenting case material
1133
consider possible rejoinders. One is also invited to consider Chabert’s own position, which may be more difficult to define. One possible way of understanding her position is that Chabert, perhaps in line with a certain kind of French perspective, regards the case presentation as a way to revive an open-ended dialogue that would put us in touch with the dialogue that went on in analysis. According to this understanding, her concern is not with arriving at true propositions per se or with sharing experiences, but with expanding associative thinking about what happened —a process that is inherently tied to the theoretical models through which we think. This stance seems to underlie her approach to the presentation of verbatim. She considers this to be one possible (albeit at times problematic) way to facilitate a good presentation of an analysis, but in her own work usually relies on alternative ways. While differences between the approaches of Boesky, Rocha Barros and Chabert are noted, they do not seem, at first sight, to be much more than matters of emphasis or degree. All agree that both objectivity and subjectivity are needed and all would agree that some flexibility is needed regarding how to present—one need not always have verbatim. This is not surprising as one might assume that few analysts would ever say that ‘one must always’ do anything. Is there not then a real controversy at hand here? Boesky (2013b) in his rejoinder to Chabert suggests that beneath general agreements there may be more fundamental differences. The disagreement that he focuses on has to do with Chabert’s critique of his views. Interestingly, however, the clarifications that Boesky offers imply that their views are, in fact, closer than she allows for. Central to his comments in this context is the idea that process notes get their value from the analyst’s clinical understanding. It is the analyst’s clinical understanding that allows and supports the associative links and inferences that he/she makes. Presenting verbatim based on process notes is just one way among others of sharing this understanding. Despite the apparent similarity of their views Boesky might be right: agreement here may conceal more basic disagreements; what appear to be differences of emphasis may touch upon more foundational differences. For as I suggested in reference to Scarfone’s comments on this topic, stances on the presentation of case material are grounded in perspectives on the very nature of the analytic situation. What may be at issue here are, in fact, different perspectives on matters such as whether attaining truth is an analytic objective and the nature of analytic truth; on whether clinical case material can validate psychoanalytic ideas, theories and concepts and how it may do so; on the degree to which the analyst is regarded as capable, despite subjective influences, of maintaining objectivity in the analytic situation and in later reflection on it; and the degree to which our theoretical positions determine the scope of our analytic understandings and interpretations. Reading the contributions to this controversy with an eye to different underlying perspectives on such matters may enhance our understanding of the positions described and the different ways in which they deal with difficulties inherent to analytic practice and discourse. Copyright © 2013 Institute of Psychoanalysis
Int J Psychoanal (2013) 94
1134
R. B. Blass
As always the Psychoanalytic Controversy section looks forward to the active participation of the IJP readership in the discussion. For as in the case of a good clinical presentation it is often in the discussion of the paper that deeper understanding of the material presented is attained. In this case it would be especially important to hear the voice of French psychoanalysts and how they perceive the differences (or harmony) between their approaches and those of other schools on this matter. Those interested in participating are invited to submit their reflections and have them posted and discussed at: www.psychoanalysis.org.uk/ijpa/ discussion.htm
References Boesky D (2013a). What does the presentation of case material tell us about what actually happened in an analysis and how does it do this? Int J Psychoanal 94:1135–43. Boesky D (2013b). Rejoinder: What does the presentation of case material tell us about what actually happened in an analysis and how does it do this? Int J Psychoanal 94:1163–5. Chabert C (2013). Response: What does the presentation of case material tell us about what actually happened in an analysis and how does it do this? Int J Psychoanal 94:1153–62. Rocha Barros EM (2013). What does the presentation of case material tell us about what actually happened in an analysis and how does it do this? Int J Psychoanal 94:1145–52. Scarfone D (2011). Live wires: When is the analyst at work? Int J Psychoanal 92:755–9.
Int J Psychoanal (2013) 94
Copyright © 2013 Institute of Psychoanalysis
doi: 10.1111/1745-8315.12131
Psychoanalytic Controversy Introduction: What does the presentation of case material tell us about what actually happened in an analysis and how does it do this? Rachel B. Blass Heythrop College, 23 Kensington Square, London W8 5HN, UK – [email protected]
The present controversy brings together different perspectives on the nature and value of analytic case material. This topic was chosen in order to invite reflection on what appear to be differences between analysts, as well as analytic schools and cultures regarding how clinical material ought to be presented and what it is intended for. Should the material strive to present an accurate description of the analytic encounter? What does accurate mean in a context in which our emotional reactions and ways of listening are integral to the encounter? And given the biases and limitations, theoretical and personal, which influence our experience of events, our recall of them and how we choose to present them, is it ever possible to provide a somewhat objective account of what happened? What then can clinical material demonstrate, illustrate, or tell us about the analytic encounter and what can be inferred from it? These questions rest in part on how we consider the aims of analysis and the kind of understanding or truths it provides. Of special interest in this context is what is thought to be the unique position of some schools of French psychoanalysis on the presentation of case material. Most psychoanalytic schools tend to stress the importance of hearing portions of verbatim of analytic sessions (usually based on process notes written up after the session). The verbatim is commonly regarded as a kind of ‘raw material’ that in some way gives listeners or readers less contaminated access to what went on in the analytic encounter. While perhaps not free of selection bias, it is thought to provide data that potentially can be understood differently from how the presenting analyst himself may have understood it. It thus provides the reader or listener with the opportunity to assess the value or validity of what the analyst claims about the encounter and what he learned from it. In contrast, in some French psychoanalytic circles detailed verbatim accounts of the sessions seem to be regarded as secondary or even unhelpful. There are psychoanalysts who offer instead a range of reflections on their patients, associations, often couched in theoretical terms. This approach to the presentation of clinical material is not well understood by non-French analysts and mutual lack of understanding on Copyright © 2013 Institute of Psychoanalysis Published by John Wiley & Sons Ltd, 9600 Garsington Road, Oxford, OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA on behalf of the Institute of Psychoanalysis
1130
R. B. Blass
this issue is perhaps a stumbling block to efforts at dialogue between analytic cultures. Two years ago Dominique Scarfone, then editor of ‘The Analyst at Work’ section of the IJP, addressed this issue when one of the cases submitted for that section by a French analyst was so filled with theoretical formulations that Scarfone feared that it would be seen as an inappropriate presentation of clinical work. In his extended introduction to the section, Scarfone argued that what characterizes a good case presentation is that it brings to life the analyst’s struggle to understand the patient and the analytic encounter and how the struggle was resolved. It should, he wrote, provide “a ‘live wire’ connecting the reader to something still asking to be heard and eventually re-elaborated, even reinterpreted” (Scarfone, 2011, p. 756). This, he suggests, may take many forms, including theoretical deliberations on a patient. In his view, what is most important, whether the presentation is theoretically oriented or includes verbatim (data which, he maintains, cannot and should not be regarded as “raw”) is to avoid demonstrations or illustrations which bind the listener or reader to the analyst’s interpretation or way of thinking. It may be seen that this emphasis on conveying the live struggle to understand emerges from a certain epistemological stance. This is the stance that our theories and personal involvement so shape the clinical material and how we see and understand the consequences of our interpretations that any effort to directly prove a point, demonstrate the value of a hypothesis, will not be very convincing. Conviction arises from being allowed to share in the analyst’s thought processes when faced with the unknown. This approach to presentation of clinical material and the epistemological position on which it rests are clearly open to debate. The contributions to the present controversy enter into this debate and more broadly open the issue of presentation of clinical material to further reflection. Participating in this controversy are Dr Dale Boesky, Dr Elias Rocha Barros and Dr Catherine Chabert. Dale Boesky is a Training and Supervising Analyst of the Michigan Psychoanalytic Institute and is a past Editor-in-Chief of The Psychoanalytic Quarterly. Elias Rocha Barros is a Training Analyst and Supervisor of the S~ao Paulo Society and also a Fellow of the British Psychoanalytical Association where he underwent his psychoanalytic training. He was past Editor for Latin America of the IJP. Catherine Chabert is a Training Analyst at the Association Psychanalytique de France (APF) and is a professor of Psychopathology at Paris-Descartes University. She is co-director of the review Libres Cahiers pour la Psychanalyse. By bringing together analysts from different regions and from different analytic cultures—including ego psychological, Kleinian, and French approaches—who have extensive experience in presenting case material and a concern with issues of how to present it, we hoped to be able to explore differences within the analytic community on these issues. To help promote dialogue with a French perspective we first procured papers from Drs Boesky and Rocha Barros. They were asked to address the topic of ‘What does the presentation of case material tell us about what actually happened in an analysis and how does it do this?’ This request was accompanied by Int J Psychoanal (2013) 94
Copyright © 2013 Institute of Psychoanalysis
Psychoanalytic Controversy: Presenting case material
1131
elaboration of some of the questions that may arise in this context. Dr Chabert was then asked to reflect on these papers and offer her own stance. Finally, Drs Boesky and Rocha Barros were given the opportunity to respond, an opportunity which Dr Boesky made use of. The three main papers that emerged offer different perspectives but seem surprisingly compatible, with the differences being mainly matters of emphasis: Dale Boesky speaks of the importance of contextualization. This is the process of applying organizing principles that shape how we regard clinical material and make only certain psychic structures come to the fore (just as the pathologist’s application of a certain dye determines the structures that can become visible). Boesky emphasizes that in case presentations information should be provided regarding this process. We should explain why certain groups of associations or events, certain contextual horizons, are given priority in the determining interpretations offered. According to Boesky this is rarely practised. He writes: Instead of informing us about the contextualizing information by which we determine meaning and interpretations, we tend to rely on a fallacious assumption when we ‘validate’ an interpretation only on the basis of the reactions of the patient immediately after the interpretation. (Boesky, 2013a, p. 1138)
Readers may consider whether this depiction of common practice corresponds to their own experience. Perhaps its validity depends on the extent to which the process of determining meaning must be clarified according to Boesky. While many analysts (like Scarfone) would contend that in presenting clinical material they regularly consider alternative interpretations and try to describe contextual factors that impact their choice of interpretation, I think that many would also maintain that they do so within certain limits, e.g. the limits of one’s school of thought. Many analysts would hold that broader consideration of alternative interpretations is needed only in the situation of debate between schools. Similarly, one may question the extent to which contextual horizons can or should be made consciously present; whether having implicit contextual horizons is not integral to understanding clinical material and its presentation in a live and vivid way. It will be noted that Boesky’s focus is on interpretations per se. That is, what need to be explained are the grounds of interpretations, how they are inferred, and the role of contextualization in the inference process. In this context, he considers process notes to be an especially valuable source of information. A major concern of Rocha Barros’s paper is how one can in the context of a case presentation convey the live experience of the analytic encounter. This is a problem, he explains, because of the distance (physical and temporal) of the listener/reader from the actual occurrence of the experience and the fact that experience is not something that can be fully captured by words. Rocha Barros’s solution is “to use a style that evokes expressively a similar experience” (2013, p. 1146). This, he argues, entails restoring the meaning of the experiences. Rocha Barros also stresses that in evoking Copyright © 2013 Institute of Psychoanalysis
Int J Psychoanal (2013) 94
1132
R. B. Blass
experience the analyst should take care not to force the experience on the reader/listener but rather leave space for his projections and the expression of his own views. It is this space that allows for critical examination of the analyst’s way of thinking. Discussion of the question of how this takes place occupies a good part of the paper, with Rocha Barros elaborating the kind of poetic skills that are required of the analyst for this. He also, however, refers to a tension between the analyst’s wish to share the analytic encounter in a way that invites reflection and the fact that he needs to and should selectively present material in order to convincingly illustrate his point. (It would seem that Rocha Barros differs with Scarfone on this necessity.) One should note that while Rocha Barros emphasizes experience he is also concerned with the validity of the meanings, theories and concepts which are manifested in the experiences or inferred from them. But the reader will note that his stance in regard to validity differs in several ways from that of Boesky. Dr Chabert opens her discussion of the papers of Boesky and Rocha Barros with an exposition of what she regards as essential to Freud’s theoretical models. This theoretical emphasis (which may be surprising to some readers) emerges as integral to her thinking about the presentation of case material. It highlights the context of interpretation that she considers relevant to an analytic case presentation and also explains the latent forces in the analyst that work against the overt aim of presenting in a meaningful and communicative way. According to Chabert, not only are there inherent obstacles to presenting what happened in an analysis (of the kind that Rocha Barros emphasizes) but also dynamic forces—e.g. we wish to guard the intimacy of the analytic encounter and experience its presentation as an act of betrayal (Chabert, 2013, p. 1153). Like our patients we wish, in part, to avoid the change that comes with communication; and our narcissistic needs drive us to communicate in a way that produces approval of our work. Chabert maintains that Boesky and Rocha Barros, in their accounts of how to present an analytic case, capture very different, although not necessarily opposed, aspects of how we relate to the analytic situation. The one focuses on our efforts to objectively assess our understanding and the other on the efforts to subjectively convey our experience. While Chabert thinks that there is value to both approaches, she also thinks that each has limitations. She maintains that Boesky is striving for an unattainable certainty, a correct or true interpretation, which he hopes to demonstrate through contexualization and through presenting the raw data of the verbatim. But this, Chabert argues, does not adequately take into account subjective influences, including those that impact on the presentation of the verbatim. In contrast, Rocha Barros, according to Chabert, is too subjective. Analysis refers to a reality, not a fiction, experience cannot be separated from theory, and our theories and concepts need to be put to the test in the course of case presentations. Therefore, Chabert concludes, poetics is not enough to present what went on in the analytic situation. In this context, the reader of this controversy will be invited to assess the critiques and Int J Psychoanal (2013) 94
Copyright © 2013 Institute of Psychoanalysis
Psychoanalytic Controversy: Presenting case material
1133
consider possible rejoinders. One is also invited to consider Chabert’s own position, which may be more difficult to define. One possible way of understanding her position is that Chabert, perhaps in line with a certain kind of French perspective, regards the case presentation as a way to revive an open-ended dialogue that would put us in touch with the dialogue that went on in analysis. According to this understanding, her concern is not with arriving at true propositions per se or with sharing experiences, but with expanding associative thinking about what happened —a process that is inherently tied to the theoretical models through which we think. This stance seems to underlie her approach to the presentation of verbatim. She considers this to be one possible (albeit at times problematic) way to facilitate a good presentation of an analysis, but in her own work usually relies on alternative ways. While differences between the approaches of Boesky, Rocha Barros and Chabert are noted, they do not seem, at first sight, to be much more than matters of emphasis or degree. All agree that both objectivity and subjectivity are needed and all would agree that some flexibility is needed regarding how to present—one need not always have verbatim. This is not surprising as one might assume that few analysts would ever say that ‘one must always’ do anything. Is there not then a real controversy at hand here? Boesky (2013b) in his rejoinder to Chabert suggests that beneath general agreements there may be more fundamental differences. The disagreement that he focuses on has to do with Chabert’s critique of his views. Interestingly, however, the clarifications that Boesky offers imply that their views are, in fact, closer than she allows for. Central to his comments in this context is the idea that process notes get their value from the analyst’s clinical understanding. It is the analyst’s clinical understanding that allows and supports the associative links and inferences that he/she makes. Presenting verbatim based on process notes is just one way among others of sharing this understanding. Despite the apparent similarity of their views Boesky might be right: agreement here may conceal more basic disagreements; what appear to be differences of emphasis may touch upon more foundational differences. For as I suggested in reference to Scarfone’s comments on this topic, stances on the presentation of case material are grounded in perspectives on the very nature of the analytic situation. What may be at issue here are, in fact, different perspectives on matters such as whether attaining truth is an analytic objective and the nature of analytic truth; on whether clinical case material can validate psychoanalytic ideas, theories and concepts and how it may do so; on the degree to which the analyst is regarded as capable, despite subjective influences, of maintaining objectivity in the analytic situation and in later reflection on it; and the degree to which our theoretical positions determine the scope of our analytic understandings and interpretations. Reading the contributions to this controversy with an eye to different underlying perspectives on such matters may enhance our understanding of the positions described and the different ways in which they deal with difficulties inherent to analytic practice and discourse. Copyright © 2013 Institute of Psychoanalysis
Int J Psychoanal (2013) 94
1134
R. B. Blass
As always the Psychoanalytic Controversy section looks forward to the active participation of the IJP readership in the discussion. For as in the case of a good clinical presentation it is often in the discussion of the paper that deeper understanding of the material presented is attained. In this case it would be especially important to hear the voice of French psychoanalysts and how they perceive the differences (or harmony) between their approaches and those of other schools on this matter. Those interested in participating are invited to submit their reflections and have them posted and discussed at: www.psychoanalysis.org.uk/ijpa/ discussion.htm
References Boesky D (2013a). What does the presentation of case material tell us about what actually happened in an analysis and how does it do this? Int J Psychoanal 94:1135–43. Boesky D (2013b). Rejoinder: What does the presentation of case material tell us about what actually happened in an analysis and how does it do this? Int J Psychoanal 94:1163–5. Chabert C (2013). Response: What does the presentation of case material tell us about what actually happened in an analysis and how does it do this? Int J Psychoanal 94:1153–62. Rocha Barros EM (2013). What does the presentation of case material tell us about what actually happened in an analysis and how does it do this? Int J Psychoanal 94:1145–52. Scarfone D (2011). Live wires: When is the analyst at work? Int J Psychoanal 92:755–9.
Int J Psychoanal (2013) 94
Copyright © 2013 Institute of Psychoanalysis
