In social work school, in my internships, I was required to produce what they called “process recordings.” After a “clinical encounter,” I would write up a three-column account of the encounter. In the left, most dense, column, I would write an after-the-fact reconstruction of the transcript of it, from memory. In the center column, I would write an account of what I was thinking at each particular moment of the encounter, as best as I could recall. And, in the third column, I would write my feelings at each moment – again, as best as I could recall. My supervision then would consist of reviewing and discussing these process recordings. They served as the prime instrument of supervisory guidance and instruction.
When I began psychoanalytic training, once again, my supervisor asked me to produce process recordings. It turned out, she meant something quite different. What she meant was simply the first column: the after-the-fact reconstruction from memory of the transcript of the session. Somehow – although this was psychoanalytic training – it seemed she wasn’t interested in my thoughts or feelings. Or at least, that the explicit reporting of them somehow exceeded the requirements of this particular assignment.
Now, I never liked writing process recordings. In social work school, I found them onerous, tedious, exhausting, and worst of all, time consuming. In analytic training, they were all that, and more: my supervisor – and indeed, the culture of psychoanalysis writ large – consistently treated the process recordings as if they were, in fact, literally accurate, complete transcriptions of precisely what happened in session. And of course, this could not possibly be true.
I raised this issue, repeatedly: “The one thing I can be sure of is that whatever I write in a process recording is not accurate!” I would say. I would confess to the temptation – and the reality – of shading the truth, to make me look somehow “better,” to make my patients somehow more “interesting.” I would confess to omitting sections of sessions willfully at times, and to altering – both consciously and unconsciously – what happened to conform to my wishes and needs. My supervisor – someone I like and respect, to this day – pooh-poohed me. “Don’t worry about it,” she said. “Just do your best.”
A few months in, I suggested a revision to our approach: I enjoy writing narratively. What if, instead of writing process recordings, I were to write little stories about my sessions. Narrative accounts of them, recounting yes, dialogue, but also the omitted thoughts and feelings, as well as doing so in a form that felt (to me) much more honest, accurate (or rather, overtly subjective and not making claims of accuracy greater than could be supported), and useful.
“No,” my supervisor said. (While I like and respect that particular supervisor, I do not think she handled this particular situation as I might have.) “Let’s stick with plain old process recordings. It’s how I was trained, and it’s how we do it.” This, of course, did not persuade me of anything, and it launched a few years of my acting out. I recorded sessions – with my patients’ permission. I transcribed them live, on my phone, with my fingers – again, with their permission. Anything to avoid the tedium – and, to me, dishonesty – of the task being demanded of me.
Why didn’t my supervisor think with me? Why didn’t she give me a persuasive, thoughtful rationale for the process recordings she wanted? I’m not sure. Only now, after the end of my training – a training in which, I confess, almost all of the process recordings I used for my control supervision were – in implicit (if not explicit) violation of the expectations of my institute – live transcripts of my sessions, recorded first by finger on my phone and then, once the pandemic began, by fingers on my keyboard – only now can I formulate what I wish my supervisor had said to me. I think my mode of generating process recordings was… fine. It worked for me. My training went well. I’m a good analyst. And I think her mode also would have been… fine. Though I imagine it wouldn’t have worked so well for me – not, at least, without a lot of thought and conversation. I also think my proposed method – the narrative reconstruction – would have worked well. It probably would have worked best for me. [Or maybe I’m a little self-deceived. Maybe I was just too willful to accede to anyone else’s wishes. Who knows? ¯_(ツ)_/¯
What would Freud do?
In his 1912 paper, “Recommendations to Physicians Practicing Psycho-Analysis,” Freud wrote an extended passage that bears on my experience of process recordings, in which he introduced the notion of “evenly suspended attention.” The tl;dr is that clinicians “should simply listen, and not bother about whether [they are] keeping anything in mind” – that this is “the necessary counterpart to the demand made on the patient [to] communicate everything that occurs to [them] without criticism or selection.” We shouldn’t take notes. We shouldn’t be trying to remember what happens in a session. [Later, he recounts that the way he handled note-taking was to “write them down from memory in the evening after work is over.”]
This admonition is ineluctably at odds with the way (at least my) training proceeded: I was required to produce a hefty volume of process notes – as many as eight or ten or twelve a week, at the peak of my training. It’s all well and good to offer that theoretical instruction that I should go home at the end of my day and write down my notes from memory. But unlike Freud, I had the benefit of neither mania nor cocaine – and a quite different relationship with my family. So I spent a not-inconsiderable chunk of mental energy during sessions trying to remember what my patients were talking about, thinking about what I wanted to be sure not to miss in my process recordings. And, in some instances (gasp) actually taking notes during session. (Shhh. Don’t tell!)
In retrospect, I wish I had taken a whole course on process recordings. As it was, some fellow candidates and I met regularly for a bit to discuss our various relationships to process recordings, the feelings we had, the strategies we employed. But it all would have benefited from a bit of theoretical reflection in the company of those more experienced than us. Maybe I’ll teach such a course some day!
And finally, just for fun: I asked ChatGPT to create an image of a process recording, and this is what it came up with:
