Do you work with patients in strategic ways based on attachment style, personality type, etc.?
I haven’t read much Bion (I confess – I find him often impenetrable, even though I have the sense that if someone smart taught me about him, I would like him better), but I like the “without memory and desire” admonition he offers. When I imagine I know something about a patient (or myself, for that matter), I’m almost always wrong. Or maybe not “wrong,” but more like, when I think I know something, I often find that if I’m not wrong, my imagining that I know a thing nonetheless can get in the way of my learning other things. Consequently, I try to hold on to what I imagine I might know as loosely as possible.
I try not to calculate, or to work strategically in ways informed by diagnostic categorizations or taxonomies like attachment styles. That’s not, at all, to say that I don’t find those various ways of thinking helpful as I conceptualize my patients, and my work with them, but rather, to say that I try pretty hard not to be strategic, most of the time, and rather, just to arrive wherever the patient is, and to listen.
