You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
In this humanely drawn and thoughtfully researched volume, Kathryn Zerbe—author of The Body Betrayed: Women, Eating Disorders, and Treatment (1993)—returns with a work that is both clinically rigorous and emotionally resonant. Secrets in Psychotherapy: Stories that Inform Clinical Work weaves together patient narratives, collegial reflections, and cultural references from literature and film to explore the psychic architecture of secrecy. With compassion and steadfast curiosity, Zerbe examines the ubiquity of secrets: those we keep from others, those we keep from ourselves, and those kept from us. For some patients, secret keeping has become a requirement for psychic survival, but it is often at great cost: the vertical split may be borne by the corporal body, now charged with paying the bill. With great insight and humility, Zerbe discusses ways the practitioner's attunement to their own bodily states can be used to ferret out the presence of the unspeakable. It is through our countertransference that the unthought-known (Bollas, 1987) may first avail itself of empathy and interpretation.
Zerbe's organizing thesis is that secrets can function as dynamic structures which shape identity and relational patterns. With much energy spent on defensively not knowing the known, the bearer has less ability to nurture healthy libidinal ties, integrate aspects of the self, work through conflicts and thrive despite the occasional narcissistic injury. Citing classical psychoanalytic theories pertaining to hysteria, anxiety and repression, attachment research and contemporary neuroscience, Zerbe writes with empathy about the psychic exhaustion that accompanies this disavowal. Like an overleveraged portfolio in which most of the mental assets are invested in shoring up the split, the mind is unable to impart energy to other self-building endeavors. Here, Zerbe also considers the intergenerational transmission of trauma whether due to war, genocide, racism or displacement. These unf