Congress 2023 – Returning to The Clinical Case Study

Congress
Saturday, 18th November 2023
10:00 - 16:15 GMT
Royal Marine Hotel, Marine Road Dublin

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The Congress will be an in person event and via livestream

Keynote Speakers: Rik Loose and Stijn Vanheule

“To say that the subject upon which we operate in psychoanalysis can only be the subject of science may seem paradoxical. It is nevertheless here that a demarcation must be made, failing which everything gets mixed up and a type of dishonesty sets in that is elsewhere called objective; but it is people’s lack of audacity and failure to locate the object that backfires. One is always responsible for one’s position as a subject. (…) The psychoanalyst’s position leaves no escape, excluding as it does the tenderness of the beautiful soul.” [Lacan: “Science and Truth”]

This Congress interrogates the clinical case study. Can the case study highlight the knowledge of the psychoanalyst in line with ethical responsibilities while also providing an interface with the demands of academic and scientific discourse?

A daring his/her-story, the case study invites its audience to engage with theory as practiced. Personally riveting, clinically relevant, theoretically illuminating and subjectively energising, the case study can be the anti-thesis of a deadening objective narrative. As a work of qualitative research, the case study can offer psychoanalysis an interface with the discourse of science and the demand for ‘evidence based’ research.

Case studies present ethical responsibilities that may be difficult or impossible to fulfil. These concern the contract of confidentiality between analysand/analyst and the responsibility of placing psychoanalysis as a theory and practice within the order shaped by a demand of the Other, something that Lacanian practice and the singularity of the unconscious as its fundamental principle was created to immanently resist.

Freud’s clinical case exemplifies and tests his theory; Lacan uses the clinical case to illustrate a paradigm, the right time to act, or the wrong turn to take. Candidates for APPI’s Reg. Pract. present a clinical case to testify to their relationship to psychoanalysis and their competence in psychoanalytic theory and practice.

These aspects of the case study make it an excellent theme for Congress in this moment when membership energy for the Reg. Pract has waned and psychoanalysis in Ireland explores how it is recognised in a broader background of humanities, scientific research and competition for academic funding.

Carol Owens will host the Congress

Carol Owens is a psychoanalyst and Lacanian scholar in Dublin. A member of the APCS, APPI, and CPUK, she is also the founder of the Dublin Lacan study group. She is series editor for Studying Lacan’s Seminars at Routledge, and reviews coordinating editor at Psychoanalysis, Culture and Society. Recent publications include Precarities of 21st Century Childhoods: Critical Explorations of Time(s), Place(s), and Identities (with Michael O’Loughlin and Louis Rothschild, Lexington Books, 2023) and Psychoanalysis and the Small Screen(s): the year the cinemas closed (with Sarah Meehan O’Callaghan, Routledge, 2023).

ABSTRACTS & BIOS.

Rik Loose – The Psychoanalytic Case and the Demands of Academic and Scientific Discourse:

The first sentence of the call for papers for this congress asks a question: Can the case study highlight the knowledge of the psychoanalyst in line with ethical responsibilities while also providing an interface with the demands of academic and scientific discourse? This question suggests the possibility that a case study needs to satisfy certain ethical criteria whilst at the same time also satisfying academic and scientific ones. My answer to this question is: No! In my presentation to the congress, I intend to elaborate on this answer by arguing that the knowledge at stake for the psychoanalyst cannot satisfy the criteria of ethical responsibility in psychoanalysis and those of academia or science both at the same time. Lacanian psychoanalysis is an orientation towards the real which implies that every case and its construction turns around an impossible point. Lacan at one point defined the real as impossible, but this is, of course, not incompatible with science, logic, or an academic approach if we keep in mind, for example, Heisenberg’s uncertainty principle, Godel’s incompleteness theorem and Russel’s paradox. However, things change somewhat when not too long after his definition of the real Lacan’s adds something crucial to it, namely, the real is the impossible to bear. In a sense, this changes everything in that this definition is not just logical anymore but adds suffering, including the suffering of the body, a body that bears (too much) weight. It is indeed the ethical responsibility of the analyst to bear the real of the clinic with his or her body to allow the analysand to reach the real of his or her body to make it more bearable. This real or One (as Lacan called it) of the body is singular. In other words, it has no comparison or cannot be identified to anything and thus cannot be proven or predicted. This singularity falls outside any scientific or academic grasp and thus the clinical case cannot form an interface with these latter two as the case can only be constructed around this point of radical singularity if it is to satisfy the criteria of an analysis that aims for the real. This point of singularity cannot be but grasped or understood but its approach can be articulated and heard and that is what the testimony of the pass demonstrates. Although I am reluctant to use the word paradigm, the testimony of the pass is the paradigm of the psychoanalytic case presentation.

Bio

Rik Loose is a member of ICLO-NLS, APPI, the NLS (New Lacanian School), and the WAP (World Association of Psychoanalysis). He is former Head of Department of Psychoanalysis in DBS School of Arts and former Senior Lecturer there. He is the author of a book on psychoanalysis and addiction as well as numerous articles in the wider Lacanian field.

Stijn Vanheule – Why Psychoanalysis is Married to the Case Study

Psychoanalysis is the discipline that questions the paradoxical and treats the unpredictable, allowing these aspects of human functioning to regain livable proportions. Psychoanalysis addresses the remnants of mental life, which Freud classified as the unconscious and the drive, and which Lacan further refined by introducing notions like lack, jouissance, object a, and non-rapport. Interestingly, its focus not only contradicts the workings of the cogito in mental life, but also contrasts with how the human being is conceptualized in mainstream psychology and psychiatry. The latter disciplines emphasize the particular; what can be predicted and generalized. In contrast, psychoanalysis is centered on the universal and the singular; on what defines our humanity and what eludes mastery. Simultaneously, psychoanalysis’ focus is rigorous and lends itself to thorough study and examination. Our chosen method for this is the case study, which, aided by the practice of supervision, guides the analyst in articulating how the encounter with non-rapport manifests within the transference.

Bio

Stijn Vanheule, Ph.D., is a clinical psychologist, professor and chair of the Department of Psychoanalysis at Ghent University (Belgium), and psychoanalyst in private practice (New Lacanian School for Psychoanalysis and World Association of Psychoanalysis). He is the author of multiple papers on Lacanian psychoanalysis, psychoanalytic research into psychopathology, and clinical diagnosis, and of the books “The Subject of Psychosis: A Lacanian perspective” and “Psychiatric Diagnosis Revisited”. Early 2024 Other Press will publish his new book “Why Psychosis is not so Crazy”. Together with Derek Hook and Calum Neill he is the editor of the book series “Reading Lacan’s Ecrits”.

Papers also read by:

Olga Cox Cameron – A Beckettian Project: Fail Better.

From what angle does one present a case history? Implicit in the whole venture is the assumption that there is something to be learned, and that this will be congruent with some aspect of psychoanalytic theory. The risk here is that accounts of success always fetch the analysand up onto the same boring shoreline, while casting an approving back light on the analyst.

It is remarkably difficult to avoid the pitfall of setting oneself up as a good analyst. Even when presenting a mistake or a miss-step the assumption is that it has been recognised by the presenter and is not an everyday example of ongoing blind incompetence. It is really not easy to show how an analysis works. Analysands who do not themselves become analysts are reticent. The novelist George Perec writes of an immobile time in an improbable space, yielding imperceptibly to the possibility of the words by which he would name himself. Analysands who do go on to become analysts tend to demonstrate how a given theoretical framework contributes to this work. But is this in itself not problematic? I would like to look at Lacan’s examination of Ella Sharpe’s Dream Analysis in Seminar 6, where two brilliant theory-driven fragments of case history collide, to show that the case history per se is always seriously inadequate while being inescapably necessary. Weirdly the student clinician (all of us) can learn more from fiction as Freud saw when he devised a training course foregrounding the study of literature.

Bio

Dr. Olga Cox Cameron has been in private practice for the past thirty five years. She lectured in Psychoanalytic Theory and also in Psychoanalysis and Literature at St. Vincent’s University Hospital and Trinity College from 1991 to 2013 and has published numerous articles on these topics in national and international journals. She is the founder of the annual Irish Psychoanalysis and Cinema Festival, now in its 13th year . And in 2021 published Studying Lacan’s Seminar VI: Dream, Symptom and the Collapse of Subjectivity (Routledge 2021).

Dr. Leon S. Brenner (Ph.D.) – The Autie-biography as a Clinical Case Study

Autobiographical writing is often not recognized as a legitimate case study for clinical practice and research. This phenomenon is referred to in this paper as “autobiographobia,” which refers to the fear of autobiographical writing that exists in clinical and empirical circles. Despite this phobia, there is a growing trend among scholars to recognize the social, psychological, ethical, and political value of autobiographical life narratives of mental illness and disability. This paper examines the case of “autie-biographies”—autobiographies written by autistic individuals—and their significance for the development of psychoanalytic metapsychology and the treatment of autism. The paper argues that autie-biographical life narratives not only provides clinical material that enables us to understand what autism is (rather than just who autistic people are) it is also described as a means for autistic individuals to assert their agency and establish their identity in relation to their bodily experiences. By telling their own story, autistic individuals can shape the way others perceive them and create a sense of coherence between their past experiences and present identity. Overall, this paper highlights how autobiographical life narratives can serve as a case study, providing valuable resources for clinicians, researchers, and individuals seeking to understand their own experiences with mental illness or disability.

Bio

Dr. Leon S. Brenner (Ph.D.) is a psychoanalytic theorist and psychoanalyst based in Berlin. Drawing from the Freudian and Lacanian traditions of psychoanalysis, Brenner’s primary interest lies in understanding the relationship between language, culture and psychopathology. His book, “The Autistic Subject: On the Threshold of Language,” was a bestseller in psychology published by Springer in 2021. He currently serves as a research fellow and lecturer at the International Psychoanalytic University (IPU) Berlin.

Geraldine McLoughlin – The Clinical Case Study and intersubjectivity: Reflections for supervisory practice

The psychoanalytic supervisory relationship is complex, multi-faceted and challenging. From Freud’s Wednesday gatherings to current times the matter of supervisory dynamics has undergone significant shifts not least because of mandatory requirements to produce ‘evaluations’ of supervisees’ practice within the psychoanalytic and psychotherapy schools. Contracted roles have focused on the presumed authority of the Supervisor, as gatekeeper, mentor, tutor and judge and research on supervisees’ lived experiences in terms of their supervisors’ input and practice are mixed, ambiguous and at times very unsatisfactory.

This paper aims to examine the evolution of Lacan’s approach to supervision which distinguishes between the registers of the symbolic, the imaginary and the real which underpins his statement that the psychoanalytic process does not focus on the patient’s actions in his/her everyday life, but ‘attends’ to the unconscious logic underlying same.

The Supervisor has to ‘hold’ an inter-connecting set of roles in embracing the role of Supervisor in the first instance, separating it completely from the role of the analyst. Lacan removes the Supervisor/supervisee from the institutionalisation which impinges on most supervisory relationships, creating the possibility of ‘transference’ between supervisor and the supervisee with the focus on the client’s enunciation, leading to ‘full speech’.

The concept of ‘intersubjectivity’ will take into account early philosophical thinking about what it is to be a subject; the analyst is to be encouraged by the Supervisor to focus on language, not meaning; the unconscious is structured like a language; the Supervisor and supervisee are engaged in a dialogic grappling with the signifier and the signified, noted in relatedness to the clinical case study being articulated in the ‘here and now’ of the session.

Bio

Geraldine McLoughlin is a trained psychoanalytic psychotherapist with a Master’s in Psychological Science from St Vincent’s School of Psychotherapy. She has also completed a Diploma in Reflexive Supervision. Clinical work also included the provision of long term psychodynamic group therapy and experiential group workshops on symptomatology and long term effects of early childhood trauma. Geraldine’s clinical work includes the provision of expert testimony to the Courts and she provides Organisational Role Analysis to senior management. Geraldine is currently completing a Master’s in International Human Rights Law having already submitted her Thesis “In the Shadow of the Law: institutional abuse victims’ search for Truth and Justice”. She continues her training in Restorative Justice Mechanisms. Geraldine’s recent clinical work includes the provision of therapy to clients who are “whistle-blowers”.

John Foden – “The analytic situation selects from a subject’s experience, what is capable of entering into a story or narrative. In this sense, ‘case histories’ as histories constitute primary texts of psychoanalysis”. Ricoeur, Paul. (1977) Psychoanal. Q., (86)(4):811-833

The clinical vignette is part of the psychoanalytic oeuvre, Freud used the case history to illustrate and illuminate his theories of psychoanalysis from the beginnings of his work. In one of his earliest expositions, “Fragment of an analysis” (1905), VII, Std Ed. He states that; “No doubt it was awkward that I was obliged to publish the results of my enquiry without there being any possibility of other workers in the field testing and checking them. [and], It is certain that the patients would never have spoken if it had occurred to them that their admissions might possibly be put to scientific use, and it is equally certain that to ask them themselves for leave to publish their case would be quite unavailing” (Freud 1905, p. 8).

Freuds disregard for the patient’s rights would not be tolerated today. But the question remains whose narrative is the vignette or case history. Few analysands imagine in their analysis that their material might be used in the future. Today, Psychoanalysts and Psychoanalytic Psychotherapists use a range of methods for protecting the patient’s anonymity and preserving their confidentiality. But it might be useful to question how we do this and what might be lost and gained in the process.

But why is the vignette important, what does it reveal? The use of a case representation illustrates something that is perceived to have happened in the analysis by the analyst. This perception may be shared or disagreed with by the analysand. The vignette may be used to illustrate an experience or a theoretical perspective. But in that process of being thought about, systematised, and described, the experience has been filtered, possibly reshaped, crafted by its selection and the sequence of presentation. Whose narrative, is it?

The presentation of a case history presents ‘selected facts’ deriving from hours of intuition, inferences and the internal unconscious of analysis and patient, which are often pre-symbolic and possibly somatic. In the eyes of other disciplines this is our Achilles heel. A psychology student once laughed at my presentation and stated, “It’s all in your subjective mind”.

We do not see ourselves presenting concrete evidenced based material, but what are we doing when we present? Through our presentations and reading of case material we gain insight, understanding and possibly new theoretical perspectives, and a sense of collegiality with our colleagues. Sometimes such discussions can cause the opposite when there are divisions, animosities, and political considerations. There may be occasions where we are not even speaking the same language, where different theoretical perspectives are difficult to bridge.

In this paper I hope to think about the clinical case presentation. To question something that has been and is part of the way we work, and who we are.

Bio

John Foden is a Psychoanalytic Psychotherapist in private practice. He is a training analyst and supervisor. John worked for the HSE for 30 years initially as a social worker and then as a psychotherapist with the National Counselling Service, becoming Director of Counselling for HSE West from 2013 to his retirement in 2018. John has held the position of chair of the IFPP and subsequently chair of the IIPP. He is currently an occasional lecturer with Trinity College Dublin and the University of Galway.

Tentative Schedule:

From 9:45am Register in-person and via live stream

10:00 – 10:15 Welcome by Congress Host, Carol Owens & Opening Comments from Chair

10:15 – 11:00 Rik Loose – Keynote speech

11:00 – 11:30 Olga Cox Cameron.

11:30 – 11:45 Coffee break

11:45 – 12:15 John Foden

12:15 – 13:00 Leon Brenner

13:00 – 14:00 Lunch

14:00 – 14:45 Stijn Vanheule – Keynote Speech

14:45 – 15:15 Ger McLoughlin

15:15 – 15:30 Coffee break

15:30 – 16:15 Panel Discussion

Wine & Canapés to follow.

Questions are encouraged and will be taken after each paper as time allows.

Ticket Prices (for both in person and those attending via live stream):

Students: €30.00 Members: €60.00 Non-members: €75.00

Who should attend?

It is open to anyone interested in this important topic. This event is of particular importance/interest to psychoanalysts, psychotherapists and anyone working in the broad psychotherapeutic field.

Confidentiality

Where any confidential material is discussed, attendees are asked to respect that.

CPD

Five CPD points are awarded for this event.

Recording

The event will not be recorded. No recording is permitted.

No refunds