I. Analytic Third or Law? Reflection vs. Regulation in Psychotherapy Case Notes

Abstract

Sally Swartz’s impassioned and poetic rendering of the possibilities of psychotherapy case-note writing as a forum in which to reflect and generate new interpretations on her therapeutic encounters inspired in me a sense of simultaneous exhilaration and envy. Her juxtaposition of Ogden’s (1994) notion of the ‘analytic third’ and other intersubjective psychoanalytic theorists (Stolorow and Atwood, 1992) alongside feminist, postcolonial and dialogical theorists, applying these to her work as a white African woman therapist with black and white clients (men and women), does indeed indicate something of the radical potential of such resources. The extracts from her therapy notes convey something of the struggle to find a way to forge communication across complex and interweaving power relationships that–in a therapy situation, as all others perhaps–are both structural and personal, and shift from moment to moment with particular effects and affects. As both (group) therapist and academic, I ache to see such work happen here in the postcolonial ‘centre’. For it speaks of real engagement and commitment to use therapy as an arena to explore the impacts and insults of racism, sexism and heterosexism in all their meticulous, gross and microscopic inscriptions on our bodies and minds. I know such work happens here (and I have tried to contribute to some of this–cf. Aitken and Burman, 1999; Gowrisunkur et al., 2002; Walker et al., 2002) – but it is becoming increasingly difficult to write and talk about. In the name of protecting the public and transparency, and in a climate where professions are both required to regulate their own practice and are increasingly subject to state scrutiny, psychotherapists in the UK are being recommended by their training organizations to keep as few notes as possible, and certainly not to own up to writing extensive notes. The legal ambiguities surrounding the notion