Case Conference: Imagining the Patient

2-Year Certificate Program (2YCP)
2022-23, 3rd Term — Mondays, 8:00-9:15pm
Michael R. Allison, MA LMHC
Michal Inspektor, LICSW


Welcome to your first case conference of the 2 year program! Michal and I are looking forward to facilitating your learning through presenting cases and listening to each other’s case presentations in a semi-structured environment. Our hope is to create an open, curious, and inclusive space for the presenter to discuss their clinical work.

What are the qualities of a productive case presentation? How can we listen and participate in a case presentation in ways that allow both presenters and listeners to deepen their experience of clinical process, and apply psychoanalytic theory to our practice? These are the questions we invite you to consider as we begin this time together.

The idea of imagining the patient has several connections to psychoanalytic theory, most notably Balint’s notion of dreaming the patient which has been developed and adapted into a case consultation model. It is important to remember that we as therapists create an internal model of the patient as we listen and engage with them in our offices. We are, in a sense, imagining who they are by (1) listening carefully to their content and process of presenting themselves to us, (2) observing their non-verbal presentation, and (3) paying careful attention to our own thoughts, feelings and sensations as we listen to them.

In this case consultation. we invite you to go through a similar clinical process as you present and participate in each other’s presentations. I often find that I learn as much (or more) from listening and engaging with someone else’s presentation as when I present my own cases.

Michal and I would like to develop the concrete aspects of our structure with you in the first class on Monday January 30th. Options include rotating the presenter each week, every two weeks, or having one presenter throughout the term. Because we will be orienting and developing our structure in the first week that means we only have seven sessions to consult on cases, so it is unlikely that everyone will have a chance to present a case this term.

We would like each presenter to assemble and bring some form of process notes to your presentation. These can be as detailed as a transcript of a portion of a session, or as loose as your thoughts about the overall process of sessions after the experience.

We would like the non-presenting members of the consult group to remember that you are not supervising the cases being presented, but rather, imagining the session by bringing your questions, associations, feelings and thoughts about what might be happening between clinician and patient within the material you are listening to.

Two qualities of meaningful case consultation we strongly believe are necessary to bring as both presenter and consultant are curiosity and vulnerability. These are clearly connected for us as we present and listen to each other. Without curiosity, vulnerability and the stance of not knowing, it is impossible to discover and learn together.

As you will be also studying object relations theory during this term, we invite you to apply the theoretical concepts you are learning from that class to the presentations in our case consultation. This is not a requirement, but an opportunity to bridge theory with practice.

Please feel free to contact us throughout this time together with any questions or concerns. Also, be sure to let us know if cannot attend any of the classes. Looking forward to our time together!

—Michael and Michal

January 30, 2023

February 6, 2023

February 13, 2023

February 20, 2023

February 27, 2023

March 6, 2023

March 13, 2023

March 20, 2023