Origin Stories

A case of writer's block.

Before bed last night, I began reading Dominique: The Case of an Adolescent by Françoise Dolto trans. from the French by Ivan Kats, revised by Lionel and Sharmini Bailly. I love case studies, not for their clinical value, but because of the mystery and curiosity that animates them as character sketches, and these sketches are a composite of stories, stories inherited and retold, reenacted through (word)play, fantasy, dream, repetition, transference. The interplay of memory and interpretation (fabulation—quest for truth) infuses them with a complexity or realism that is, I find, hard to come by in contemporary fiction. In other words, the characters I meet via the case studies are far more interesting, dynamic, and considered; perhaps because they are not just characters in the sense that they are constructs or representations working in service of some other drama, but active participants who consent, reveal, obscure, and refuse.

There is also something retroactive about the form of the case study: we assume that the study can be written because something of the mystery of the person and the story of their symptoms and their suffering through the multiple tellings ends up coming into focus— though the mystery is never entirely dispelled. Thomas Ogden:

Words and sentences, like people, must be allowed a certain slippage. I do not mean to suggest that words, sentences (and human beings) can be said to mean (or be) anything we wish them to mean (or be). Rather, I am drawing attention to the stifling effect on imagination of our efforts to define, to specify with ever increasing precision, what we mean (who we are). Imagination depends on the play of possibilities. (Reverie and Interpretation: Sensing Something Human, 1997)

I suppose the doctor is ultimately interested in helping his patients lead more livable lives (one might argue lives that include space for greater possibility) but so far, what is interesting in the case of an adolescent, is the doctor’s ability to be discerning in relation to the family dynamic that surrounds Dominique. So it’s not just the analysand, or in this case, the adolescent, who is a point of curiosity for the doctor, but also the family members who enact, replicate, and live out, unbeknownst to them, of course, their own fantasies in relation to Dominique. (A similar dynamic though in a very different register can be appreciated in the recently translated Lili is Crying by Hélène Bessette.) I’m only about a third of the way through Dominique, and I am excited to see how this drama plays out. What will become of the adolescent?¹

There is a literary element to all this close listening. In the beginning of the case study, Dolto asserts: “Any man’s life, whether he is neurotic or not, involves unusual circumstances. From the point of view of psychoanalysis . . . it is not these events that are significant; it is the way the subject reacts to them, according to the organisation of his drives and personality structure at the time” (7).

Maybe what I am responding to here is the possibility that the occasion of the analysand, or the treatment, seems to set the conditions for something like fiction. The treatment is the realization of a future that has yet to come to pass, whereas the case study is the narration of that future after it has passed and become writing.

It is not for the analyst to judge or moralize the “unusual circumstances,” but to understand his patient in relation to the events’ unfolding. The analyst must be of sound mind to do this work, though it is to be expected his imperfections, mistakes, and misinterpretations will complicate the portrait. The case study is interesting insofar as it introduces the possibility of a narrator whose story coincides with a near-impossible narration, that of his patient— one that will inevitably challenge normative expectations around narrativity, subject hood, chronicity, and chronology.

As such, the case study narrates not just the transformation of the analysand or the adolescent, but the transformation of the doctor into a writer.