Structure and Spontaneity in Clinical Prose
eBook - ePub

Structure and Spontaneity in Clinical Prose

A writer's guide for psychoanalysts and psychotherapists

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  2. English
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eBook - ePub

Structure and Spontaneity in Clinical Prose

A writer's guide for psychoanalysts and psychotherapists

About this book

Structure and Spontaneity in Clinical Prose will teach you to read gifted writers for inspiration and practical lessons in the craft of writing; apply the principles and techniques of the paradigmatic, narrative, lyric narrative, evocative, and enactive modes of clinical prose; and put what you learn immediately into practice in eighty-four writing exercises.

Each of the five modes uses different means to construct worlds out of language. The paradigmatic abstracts ideas from experience to build concepts and theories. The narrative mode organizes experience through time, creating meaningful relationships between causes and effects. Lyric narratives present events unfolding in an uncertain present. The evocative mode works by invitation and suggestion, and the enactive mode creates an experience to be lived as well as thought.

Structure and Spontaneity is fundamentally a book about reading and writing in new and different ways. It is an invaluable resource for new and experienced psychoanalysts and psychotherapists and for students, teachers, editors, and writers in the humanities and social sciences.

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Information

Publisher
Routledge
Year
2015
Print ISBN
9780415882002
eBook ISBN
9781136946226

1 A Writing Workshop

One does not discover new lands without consenting to lose sight of the shore for a very long time.
André Gide, The Counterfeiters
I remember my high school physics teacher describing how many important discoveries were made when scientists set out to investigate something else. About the same time, serendipity became one of my favorite vocabulary words. The sound of it was irresistible. The exercises in this chapter are designed to send you off in new directions so that writing itself becomes a discovery process and serendipity, your travel partner. But if losing sight of familiar shores prompts you to search for flotation devices, remember what you know as a psychotherapist: You can trust the process even if you don’t know where you’re headed. That’s one way to welcome the unexpected.
In the exercises in this chapter, you may want to write about the same patient or clinical dilemma from different angles, because that focus creates a multiplying effect—call it serendipity squared. On the other hand, if you want to write about different patients, you may be led in other interesting directions. So feel free—anytime—to vary your sailing plan and chart your own course.

Portraits in a Sentence

Skilled writers can draw a striking portrait of a person or process with a few deft strokes. Here are three examples:
She wore guilt like an old sweater, familiar and all too comfortable. (Naiburg, a writing exercise)
He hurled his silence like a fast ball into a vacant lot. (Naiburg, a writing exercise)
Like watching the scattered shards of glass in a kaleidoscope suddenly cohere, all the many vital clues to her ancestry suddenly came together. (Pickering, 2012, pp. 589–590)
Exercise 1.1
  1. For this exercise, try capturing in one or two sentences something evocative about a patient, clinical process, or your therapist self. The challenge is to create a vivid miniportrait using as few sentences as possible.
  2. Create several more miniportraits. Consider jotting them down immediately after a session.

Mood Music

A seventeen-year-old patient called Andrew wrote the following self-portrait in the third year of his analysis:
… My words are lost shouts in a dead prison,
torn assemblages of thoughts in a mute body,
Or dust in the air that breathed then.
My words are stones sweeping the beach,
The pebbles thrown carelessly by innocent children,
Sinking
Swept away
By the tide.
All worn and inadequate communications.
Broken mirror: Darkened windows.
Empty shells on the shore—You can hear the sea.
But I who is words, untrained passion and solitude,
I am unaccessible, unexpressable, floating unwritable thoughts,
They are my movements and my body … (Sidoli, 1993, pp. 88–89)
Helen Grebow (2009) creates another version of mood music when she tells us how she felt at the end of a session with a new patient and imagines how her patient might feel:
At the end of the session, she bolted out the door. I realized that my breathing had become shallow and tempered. I had been gripped by the recognition that any intense movement could send shock waves through the room, undoing her and us … ending our dance at the beginning. I felt that had been her experience in so many relationships before me. Now an inextricable player, I wrote my version of her patchwork story:
I live my life in pieces—
ragged,
jagged,
frayed,
splayed,
quilted.
Piecemeal I venture into the world
Running for cover or for a cover—
Hoping the threadbare seams hold
as I gently pull my cover around me, over me—
containing me,
shaping me,
shielding me,
cushioning me,
concealing me.
Protecting the trailing threads—I step
cautiously,
tentatively,
fearfully,
gingerly,
vigilantly—
Aware that one misstep, one small catch
and
the slow unraveling will begin. (pp. 265–266)
Exercise 1.2
In this exercise I invite you to catch a feeling, sensation, or mood in words that capture something of your patient’s experience or your experience with your patient. For Seamus Heaney (2002), a poem begins even before words are formed. We could say the same thing about evocative prose: “The crucial action is pre-verbal… . Frost put it this way: ‘A poem begins as a lump in the throat, a homesickness, a lovesickness. It finds the thought and the thought finds the words’ ” (pp. 22–23).
  1. Start this exercise by feeling into that preverbal place Frost identifies and let your feelings find the thought; the thought, words; and the words, their own form as you write a mood-music piece from that embodied place.
  2. If you wrote in your patient’s voice in a, try writing in your own voice or vice versa.

Writing from the Inside Out

In “ ‘Eva, Get the Goldfish Bowl’: Affect and Intuition in the Analytic Relationship,” Barbara Pizer (2005b) enacts the stinging shame she feels when her patient calls her out for lending him one of her papers:
The hour had come to an end and I felt helpless. I could not sit with the guilt and the pain that I felt Julian experiencing. I lend him a paper I have written about holding on and letting go; about freedom to feel one’s feelings and still taking responsibility.
The next day Julian comes in to tell me that he read the paper as my relating to him my confusion, and having crossed a line! He is panicked. But not too panicked to talk about it.
“My mother,” he tells me, “was always needing me—when what I wanted was to be taken care of.”
Suddenly, sitting with Julian, I am seven years old, transported to my Grandmother’s farm . . .
“Do you think,” I say to Julian, “I am looking for you to take care of me?”
“Absolutely.” Julian is locking on. “That is clear.”
… . in the summer that my younger sister was about to be born. Ilse and I are sent away. We spend the entire month of July at Grandma’s farm, which would be lots of fun if both my parents were along . . .
“I wanted unconditional love from you,” Julian is telling me, “by a non-person. Being a person crossed the line.”
A hideous Nanny is hired to accompany us. We hate her. She spends her time reading or on the phone.
“Being a person crosses the line.”
… It is shockingly hot that summer at Grandma’s farm. I can feel the heat in my cheeks. There’s a stream in the front meadow where we are not supposed to go. We can see it from the window of the farmhouse. Ilse and I, we wriggle through the forbidden barb wire fence of that front meadow and we are walking through the high grass . . .
Julian asks me what this issue of intimacy that I write about is supposed to mean between him and me. What do I want from him? What am I really saying?
Silence is useless, Julian will not yield.
Ilse is balancing on a log across the stream when it happens . . .
“My mother paid more attention to my brothers and her best friend’s kids. They were always at the house. When I ask her about it, she tells me that I seemed so happy as a child, so self-sufficient. Didn’t need anything.”
I must have stepped squarely in a nest of yellow jackets.
“I know my mother needs me. It looks like you do too but why won’t you admit it? Why else would you give me that paper?”
Julian doesn’t raise his voice. But he is fixed on me. He says he is certain that he knows what he is talking about. Why would I not admit what I need from him?
A nest of yellow jackets. A million of them. They swarm around me without mercy. Ilse is screaming bloody murder but even I can hardly hear her over the sound of the bees.
“She needs me. You do too.”
I stand there frozen as the bees narrow in on me and settle on my skin. The more I try to brush them off, the harder they hunker down. I wonder if they know I’m shaking.
I make no argument with Julian. (pp. 27–29; italics in original)
Pizer quickly draws us into the emotional intensity and immediacy of two scenes, one narrative line on top of the other, climax on top of climax. Her present and past feelings build synergistically with each of Julian’s accusations. Her interweave is masterful. Her internal drama undoubtedly erupted as affectively loaded, wordless images and body memories intensified by the stark contrast between the turmoil she experiences internally and the professional demeanor she must maintain interpersonally. The sensation of speed is created, in part, by her syntax. Frequent repetitions of simple, declarative constructions push the reader rapidly forward as the tension builds.
“Good writing is supposed to evoke sensation in the reader,” E. L. Doctorow writes, “not the fact that it is raining, but the feeling of being rained upon” (quoted in Stein, 1995, p. 8). What Pizer feels as Julian “is locking on” is enacted in the story of her seven-year-old self as she enters forbidden territory and is stung by yellow jackets. It’s a “shockingly hot” day, and she is a culpable child, bitten “without mercy” as she stands frozen and, unbeknownst to her attackers, shaking.
Exercise 1.3
Francine Prose (2006) suggests that when writers read “carnivorously,” it is not “for what can be ingested, stolen, or borrowed, but rather for what can be admired, absorbed, and learned” (p. 31). I invite you to take what you learn from Pizer and apply her techniques to writing a clinical scene of your own, moving between your internal experience and what is happening between you and your patient, creating what Bruner (1990) calls a narrative’s “dual landscape.”
  1. Let a scene of intense engagement with a patient come to mind.
  2. Take a few minutes to recreate the memory of that experience in all its rich emotional complexity and let the feel of it reenter your body.
  3. Writing from that embodied place, give your readers as rich a sense of what it is like for you to be in relationship with your patient and yourself in this moment by creating two, intertwined narrative lines as Pizer does. Using the present tense will help you create a sense of immediacy.

“Fetching”

Frost (1995) praises a writer who forms an “unmade word” or “takes a...

Table of contents

  1. Cover
  2. Title
  3. Copyright
  4. Credits
  5. Dedication
  6. Contents
  7. Preface
  8. Acknowledgements
  9. 1 A Writing Workshop
  10. 2 The Poetry of What We Do and the Playground of Clinical Prose
  11. 3 Narrative Meaning and Technique
  12. 4 Short Stories
  13. 5 The Evocative Mode
  14. 6 The Enactive Mode
  15. 7 Lyric Narratives
  16. 8 The Paradigmatic Mode
  17. 9 Narrative Moves and Interweaves
  18. 10 Voice
  19. 11 Introductions
  20. 12 The Narrative Axis
  21. 13 The Conceptual Axis
  22. 14 Shapes of Arguments
  23. 15 Using Sources
  24. 16 Conclusions
  25. 17 Revising
  26. 18 Confidentiality and Disguise
  27. Afterword
  28. References
  29. Index

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