Responsible creativity: combining clinical report and literary writing in the psychodynamic case study

Though the case study is deeply embedded in psychoanalytic history, it has, so far, gone without theoretical conceptualization and has not been considered as a genre in its own right. I argue that the psychodynamic case study combines medical report and literary writing elements to create a unique and sophisticated hybrid genre. It resembles other types of creative non-fiction, like memoirs, historical novels, or biographies. In all these genres, the described reality does not claim to be identical to reality itself. Although analysts do not make things up, they use their imagination and writing skills to elicit their readers’ identification with the therapeutic process. The storytelling allows richer learning by capturing an essence and a deep structure, leaving an impression more lasting than a dry report. However, clinicians don’t have the creative freedom of writers of memoirs and biographies. Writing an exciting story is secondary to helping patients and broadening the community’s knowledge. The blurring of boundaries between facts and creativity presents some pertinent questions: How much creative freedom can writers of case studies take? In the case of forgotten or unknowable details–is it permissible to reproduce them? The article introduces the term ‘responsible creativity’ to suggest some lines that may guide therapists in writing case studies.