Case Conference: Meaning-Making

2-Year Certificate Program (2YCP)
2022-23, 4th Term — Mondays, 8:00-9:15pm
Charlotte Malkmus, MA LMHC

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Introduction

Welcome to Case Conference: Meaning-Making. 

We look forward to a rich time together, deepening the exploration of clinical material as a group.   The following will help orient you to our approach and focus over this term.  

We are fundamentally meaning-making creatures, yet many patients come into our offices not realizing that their actions, and interactions, indeed their MINDS, are meaningful.  As analytic practitioners, we understand that it is in the process of making meaning that our minds develop and we expand the capacity to metabolize psychic material.  It is this capacity that allows us, for example, to self-reflect, to regulate affect, and to make order out of the chaos of living.

In this course, we want to underscore the following points relating to meaning-making in the clinical setting.

• As human beings, we are constantly making meaning, whether consciously or unconsciously.
• Meaning is made through what we say, what we do, and how we be together.
• Everything that occurs in the clinical field has meaning.
• Treatment progresses through meanings that are co-created, both explicitly and implicitly.  
• In psychoanalytic psychotherapy, particular emphasis is on the meaning that emerges through the treatment relationship.
• Meaning is made over time.
• One important function of the therapist in the clinical dyad is to help the patient grow the capacity for meaning-making in her own life.
• Given that meaning occurs in many forms, the concept of psychoanalytic listening can helpfully be expanded to a notion of psychoanalytic receiving.

Please read the following selection before the first class to anchor our approach to the material during this course. 

Levin, C. B. (2016) Everything Counts: The Organizing Activity of an Interpretive Attitude. Psychoanalytic Inquiry 36:14-27.

As you read through the article, attend to the author’s attempts—both implicit and explicit—to make meaning of what the patient is trying to communicate to her and what is happening between them. Also take note of the patient’s attempts – both conscious and unconscious – to convey meaning to his therapist. We will use this case example as a jumping off point for our discussion. 

During our first meeting we will set the structure for the remaining weeks.  We would like to encourage one or two presenters to cover all of the sessions during the block, as this facilitates the opportunity to see how meaning often emerges in treatment over time.  We would like the presenter(s) to bring something close to a transcript of a session (or a significant portion of a session) each time they present, so that we can follow the arc of the treatment over multiple sessions.

Presenting work in case conference is a generous act on behalf of all of our learning;  opportunities for communal learning from shared clinical material are invaluable in our field.  The purpose of this case conference is to utilize the material for exploration of clinical ideas and the development of your own thinking, rather than to supervise the case being presented.  

We invite you to listen to each other with the same respect, safety and attention that we give our patients.  Curiosity, an openness to new experience, a sense of collegiality, and an appreciation of our own and others’ vulnerability as presenters and discussants alike, can result in a rich, rewarding and creative experience.

We hope to foster in our time together a lively process of experiential, co-creative meaning-making that brings to life the concepts we are introducing and deepens your ways of being with your patients.

April 3, 2023