Conversing With Uncertainty: Practicing Psychotherapy in A Hospital Setting PDF
Preview Conversing With Uncertainty: Practicing Psychotherapy in A Hospital Setting
CONVERSING WITH UNCERTAINTY Copyrighted Material Relational Perspectives Book Series Stephen A. Mitchell, Series Editor Volume 1 Rita Wiley McCleary Conversing with Uncertainty: Practicing Psychotherapy in a Hospital Setting In Preparation Lewis Aron Interpretation and Subjectivity Emmanuel Ghent Process and Paradox Charles Spezzano Affects and Therapeutic Action Donnel Stern Unformulated Experience Copyrighted Material Rita Wiley McCleary CONVERSING WITH UNCERTAINTY Practicing Psychotherapy in a Hospital Setting with a Foreword by Stephen A. Mitchell and an Afterword by Glen O. Gabbard THE ANALYTIC PRESS 1992 Hillsdale, NJ London Copyrighted Material Copyright © 1992 by The Analytic Press, Inc. All rights reserved. No part of this book may be reproduced in any form, by photostat, microform, retrieval system, or any other means without prior written permission of the publisher. Published by The Analytic Press, Inc. 365 Broadway, Hillsdale, NJ 07642 Set in Korinna by Lind Graphics, Inc., Upper Saddle River, NJ Library of Congress Cataloging-in-Publication Data McCleary, Rita Wiley. Conversing with uncertainty : practicing psychotherapy in a hospital setting/Rita Wiley McCleary, with a foreword by Stephen A. Mitchell and an afterword by Glen O. Gabbard. p. cm.—Relational Perspectives Book Series ; v. 1 Includes bibliographical references and index. ISBN 0-88163-148-5 1. Psychotherapy—Case studies. 2. Psychiatric hospital care— Case studies. 3. Psychotherapist and patient—Case studies. 4. Psychotherapy — Philosophy. 5. McCleary, Rita Wiley. 6. Psychotherapy. 1. Title. [DNLM: 1. Inpatients — psychology. WM 420 M478c] RC465.M39 1992 616.89'14— dc20 DNLM/DLC for Library of Congress 92-17730 CIP Printed in United States of America 10 9 8 7 6 5 4 3 21 Copyrighted Material To my parents, Dick and Francesca Copyrighted Material Copyrighted Material ACKNOWLEDGMENTS In Educating the Reflective Practitioner, Donald Schön (1987) argued that "the paradox of learning a really new competence is this: that a student cannot at first understand what he needs to learn, can learn it only by educating himself, and can educate himself only by beginning to do what he does not yet understand" (p. 93). While in many respects Schön's depiction of learning-in-action inspired the following case study, I think that here he overstates his point. To agree that I could learn to be a good psychotherapist only through my own practicing is not to detract in the slightest from the indis pensable support, guidance, and constructive criticism from others that 1 gratefully received, depended on, and used. My first thanks goes to Kay, the adolescent inpatient who tolerated my often clumsy efforts to be her psychotherapist and whose talking back yielded insights into how I was treating her that I could never have gained from a textbook. For all her very real difficulties in living, I remember her intelligence, humor, and admirable—if, at times, exasperating—stubbomess. Kay and I were both lucky to find our selves on an adolescent unit at State Psychiatric Hospital. By their example, clinical staff members taught me the value of team work in a hospital setting and positively contributed to Kay's treatment. At the Chicago School of Professional Psychology, where this book germinated as a dissertation, Dennis McCaughan, my advisor, lent me his remarkable capacity to make sense of problematic vii Copyrighted Material viii Acknowledgments materials and shape them into a reflective case study. He balanced his strong commitment to psychoanalytic inquiry with an equally deep appreciation for new and often unexpected ways of under standing. His love of ideas never lost touch with the complex situations that my own ideas attempted to approximate. Very rarely in my many years as a student did I have the good fortune to study with someone at once so talented and generous. Other colleagues and de facto advisors whose comments and encouragement have helped me include Margaret Browning, Kirsten Dahl, Lynn Reiser, Donna Robinson, David Smigelskis, Herb Wein stein, and Lee Weiss. I owe special thanks to Richard Davis for his uncomplaining willingness to read and respond to innumerable drafts, and whose unflagging confidence in the project sustained me during those long hours of figuring out what I was trying to say. I felt honored when The Analytic Press accepted my book for publication and was subsequently awed by the editors' generosity. Paul Stepansky, Editor-in-Chief, always made himself available as both a sounding board and source of complementary ideas that sparked my own. Similarly, John Kerr, who read both the initial and final drafts, provided stimulating and astute comments. Without Eleanor Starke Kobrin, TAP's Managing Editor, the book would never have seen the light of day. She coached me in the finer points of Wordstar and gently assured me that I, like other new authors, could surely compile an index. Last but not least, I want to extend special thanks to Merton Gill. Often as I struggled through the writing of this case, I thought of it as a psychoanalysis of my ideas. The confidence and stamina required to persist in such often disheartening self-scrutiny would not have been possible without his patience, wisdom, and example. Copyrighted Material CONTENTS FOREWORD—Stephen A. Mitchell xi — 1 — FIRST WORDS 1 — 2 — NOISY WORDS 13 — 3 — CONFLICTING WORDS 39 — 4 — MAGIC WORDS 59 — 5 — SHARED WORDS 78 — 6 — CONVERSATION 111 REFERENCES 133 AFTERWORD—Glen O. Gabbard 137 INDEX 151 ix Copyrighted Material
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