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Ellen Pinsky has written an extraordinarily insightful and at times surprisingly personal book, a perambulating, lively, and very literary exploration of the psychoanalytic encounter, its unique intimacy, and most especially its attendant risks. Leaning on the writings of not only psychoanalytic thinkers, but also poets, novelists, and even songwriters, Pinsky meditates with great subtlety on the fact of human fallibility as it affects the clinical encounter between two people alone in a room, a situation intentionally structured to arouse in both therapist and patient strong feelings deriving from the transference. The unconscious projection of past relations onto the present situation, transference, as Pinksy writes, is the crucible in which the clinical treatment occurs and the most potent force in determining its outcome, its success or failure. Yet I think it may be precisely the power of transference in Pinsky's personal relation to the subject of her book that may create a problem for the reader, primarily its repetitive elaborations of the effects of analytic fallibility and mortality on both patient and analyst. And as Pinsky tells us, she has occupied the position of each.
Significantly, it is the analyst's role in the transference rather than the patient's, the dangers of counter-transference, that she emphasizes, calling upon a host of classic articles beginning with Freud's “Observations on Transference-Love” (1915b). In five chapters of beautifully evocative prose, each entitled with a literary allusion that serves as a dominant metaphor for the chapter's principal subject, Pinsky extensively examines various aspects of the relationship that develops between analyst and patient, underscoring the ways in which the analyst's fallibility, his or her human limitations, can result in a therapeutic failure that is a kind of psychic death.