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Writing psychodynamically oriented clinical papers is a daunting yet important task. To understand the page-by-page challenges better, I interviewed 12 editors of 4 clinically oriented American social work journals. This paper grew out of that project. It briefly describes the peer review process and examines how editors serve as both gatekeepers and mentors. It then describes how they interpret journal guidelines for evaluating manuscripts, how they spot potential in problematic manuscripts, view a manuscript's conceptual strength, define clinical data, think about the question of "proof," and identify contributions social workers can make by writing about their clinical work. [ABSTRACT FROM AUTHOR]

Clinical writing is sometimes viewed cynically, as a way to ensure progression – through training and beyond – by demonstrating one's allegiance to received views. For candidates and faculty alike, this belief may defend against awareness of an even more troubling truth: that in writing about one's patients, one inevitably reveals a great deal about oneself. As Freud's remark on Dora's chattering fingertips implies, even writers who aspire to stay within the bounds of received wisdom may betray themselves. In this paper, I present a way of teaching Freud's first two major cases ("Dora" and "Hans") as prelude to a clinical case writing sequence at my institute. When teaching Freud, I encourage candidates to read his writing as we might hope for others to read ours: both critically and sympathetically. With perspective provided by knowledge of Freud's personal history and era, we discuss the implicit personal and political motivations that are now possible to discern between the lines of his texts. When teaching clinical writing courses, I remind candidates of our earlier, shared encounter with Freud; in writing about their patients, they too will reveal more than they can know in advance. I encourage candidates to embrace this feature of case writing, and to regard their peers and instructors as companions in a quest to understand their patients and themselves. Though I recommend including some study of Freud's cases in candidates' writing instruction, I also argue the importance of finding one's own, unique approach to teaching the practice of clinical writing, which is – for every clinician – deeply personal. [ABSTRACT FROM AUTHOR]

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This writing workshop is designed for new and experienced clinical writers. In it, I analyze thirteen writing samples (many from this issue) to appreciate the writer's craft. I discuss several writing terms and show how the samples illustrate them. You will also find twenty writing exercises and encouragement to find your own voice as a writer. [ABSTRACT FROM AUTHOR]

In this article, the author describes an unusual situation that resulted from his decision to publish a clinical report of aspects of an analysis. He asked the patient's permission to publish and she agreed. However, she also asked to read the report. The analysand had a strong reaction to the analyst's paper, particularly to his depiction of her, to which she subsequently wrote a response. The author deemed that her response was of considerable psychoanalytic interest. The analyst's paper and the analysand's response then appeared as a joint publication. The author further describes his conflicts and emotions, often painful, which arose from this written encounter beyond the analytic dialogue. In the article he also offers a psychoanalytic interpretation of the written encounter, the patient's response, and its effects on the analytic process. [ABSTRACT FROM AUTHOR]

Clinical implications and ethical dilemmas of the use of confidential case material in clinical writing are examined, including a review of the discourse among professionals who publish clinical work. This literature is applied to a clinical illustration of psychotherapy with a client who gave consent for publication and read the clinical write-up of her case material. It is suggested that clinical writing may increase client "self-reflection" if there is a "secure base" of attachment between therapist/author and the client. The impact on the client's treatment process is examined, in addition to a discussion of ethical questions and professional recommendations. [ABSTRACT FROM AUTHOR]

The author discusses her experience in seeking consent from 16 patients to use clinical material for publication. Sharing narrative case examples from her practice, she elucidates her process with patients and focuses on the beneficial and detrimental effects on the therapeutic relationship. Seeking consent raises issues of confidentiality and stimulates wide-ranging, layered and linked emotions and meanings for patients, including feelings of closeness, envy, and shame, which in some cases may lead to treatment interruptions. If the analyst actively employs this process as a therapeutic tool, across time, with openness to unexpected meanings, it may advance the therapeutic conversation and developmental possibilities. When there is a negative effect on the patient or the process, analysts' shame and guilt may be invoked and consultation is recommended. [ABSTRACT FROM AUTHOR]

This is the story of how writing a memoir while treating a client who is eventually able to disclose childhood sexual abuse helps me to understand my experience as an abused child as well as my client's. I am able crucially to accept my own and therefore my client's initially disavowed reactions to the abuse, including sexual arousal and pleasure. [ABSTRACT FROM AUTHOR]

The ethical underpinnings of writing about patients are explored, the question of how best to undertake the writing of case reports being subordinated to a more general question about the ethics of choosing how or whether to write. An unsolvable paradox is encountered here: that we need to write or speak about our clinical work in order to conceptualize and understand the work we are doing, but that in the very gesture of doing so, we are breaking a fundamental bond with the patient. This conundrum is viewed from a number of vantage points. The controversy about how best to go about writing clinical accounts is first addressed, after which the literature is reviewed to draw out the ethical conflicts that writing about patients engenders in the patient. Next attention is given to undercurrents in the analyst’s motivation to write, again drawing on current literature. Finally, a consideration is provided of how, based on what we might learn from this review, these problems can be addressed. [ABSTRACT FROM AUTHOR]