In my last post, I said I would offer some case studies as examples of how people leave in the same way they were left. The process sounds so straightforward and obvious, doesn’t it? It sounds as though the process of working out one’s own pains and wounds is so easy to see that therapy and other guidance should be practically useless by now. But we know it’s not. With all our knowledge about how all things psychological work, the modern person is still as much at the mercy of his own unconscious as he ever was–and perhaps moreso, as he has lost his spirituality and symbols through which he might otherwise externalize his inner conflicts.
It occurred to me while writing the first case study that some readers may not be aware of how analysts and other mental health professionals and healers use the case study. I thought I’d write a brief post about how case studies are usually used and then tell how I plan to use them in this series, since using them for blogging purposes will be decidedly non-standard. I guess you could say that what I plan to offer here are not true case studies, but more like case snapshots or tales of lives lived symbolically. Allow me to explain.
the case study
In the mental health professions, the case study generally is a paper or part of a client file that outlines the patient’s history, background information, a description of the presenting problem–what brought the client into therapy or treatment–and the clinician’s DSM-IV diagnosis. In a paper or journal article, the author follows the case history with a description of the course of treatment, what interventions were used to help the client, what the outcomes were, and how treatment ended. In a journal article, the author would cite any relevant references to research that upholds the treatment method. The client’s response to treatment and the effectiveness of the treatment would also be explained.
the personal myth
Along with many psychoanalysts, I regard people’s keenly-felt outwardly-manifesting difficulties as attempts to work out inner conflicts of mythic proportions. As St. Paul wrote, each of us is to “work out your own salvation with fear and trembling.” This is no simple task, for we will face our worst selves, encounter dragons, be beguiled and bewitched, receive wounds and scars, stand at the edge of more than one gaping abyss, and ultimately fall on our faces before the Living God before we are finished with this quest.
However, unlike many psychoanalysts, I am not a psychoanalyst. There is thus no need for me to write perfect, clinical case studies. Though I am calling them case studies, what I’m going to be doing is loosely using a case study format to tell stories that show what people do while still held in the thrall of their own complexes and conflicts. Although I figure that regular readers will already assume that this is what I’m going to do rather than wax dryly clinical, I thought it might be kind to alert the professional types that I’m more of a tale-teller and tea leaf reader than I am a therapist. I am not, in fact, a therapist at all. Though I have been one in the distant past, I never loved it and it was not my calling to do therapy, even if I have benefitted from my own analysis and all sorts of help along the way.
So. Let the story-telling begin. Let’s look for patterns and symbols, and see if we can learn to look with new eyes, eyes that are just a little jaded and a little more uncertain of what we see.