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by Allan Frosch, Karnac Books, London, 2012, 168pp.
This book, edited by Allan Frosch, with introduction by Allan Frosch and Fredrick Perlman, the editor of the CIPS (The Confederation of Independent Psychoanalytic Societies) series on the boundaries of psychoanalysis, contains eight papers written by members of the CIPS community addressing a wide range of concrete experience from a variety of theoretical and technical points of view. Paradoxically, the concrete experience described in these papers is not defined exclusively by what we typically understand to be concrete such as the compulsive preoccupation with bodily appearance, but rather by a quality of mind that precludes the possibility of symbolization and entertaining alternative perspectives by insisting on absolute truth and certainty of beliefs and emotional experience.
From this point of view, diverse clinical phenomena are described in these papers: intractable transferences, enactments, words used as actions, prolonged immersion in intense emotional experience and bodily preoccupations that have at their core a concreteness of thought and experience that resists and opposes an analytic process that depends for its effectiveness on symbolization, self-object differentiation and self-reflection. Analytic work with these patients is often difficult and painful for both analyst and patient resulting in a general reluctance by many in the analytic community to treat them, viewing them (in Frosch's words) as persona non grata . In contrast, the authors of these papers have actively engaged these patients often in difficult but rewarding long-term analyses. In their papers, they describe in detailed clinical vignettes their work and their struggles with counter-transference, with remarkably refreshing openness.
The authors approach their patients from the theoretical perspectives of Freud, Winnicott, Klein, Loewald and Bion. But there are common threads in the clinical material that underline a core conflict or developmental deficit that defines pathology associated with concretization of experience, that is, the inability to differentiate self and object, and experience another person and perspective as different from self. This can take the form of projective identification (Anderson), fetishistic registration and denial (Bass), co-created enacted fixed self and object representations (Goodman and Ellman) or belief in the absolute truth of one's worldview (Lasky).
Another theme running through most of the papers is that therapeutic action with these patients initially and for some time relies less...