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This collection of papers grew out of a series of symposia and discussion groups led by analysts affiliated with the Boston Psychoanalytic Institute. These analysts were concerned about the threat of nuclear annihilation. They believed that psychoanalysis occupied a unique position, beyond the responsibilities of citizenship, to overcome an almost universal denial on the part of patients and analysts of the threat to life and survival in the nuclear age.
From the fragmentary data presented in this volume, it is fair to conclude that few patients bring to their analytic hours material that ultimately discloses unconscious fears of annihilation. In turn, few analysts view the absence of such material as an indication of massive denial. Perhaps analysts are also engaged in denial and therefore collude with patients in failing to uncover the associations concerning the bomb, warfare, and the threat to individual life and the survival of civilization. Vamik Volkan, in an essay entitled "Nuclear Weapons and the Need to Have Enemies," wants analysts to go beyond investigation of defenses. "The nuclear problem should be viewed as the ultimate hazard to mental, as well as physical, health and to the very essence of life. Thus, psychiatrists and other health-care professionals should take responsibility for supporting grassroots movement against nuclear weapons" (p. 123).
Other contributors to this volume, while perhaps as passionate as Volkan, take a more cautious view of the position of analysts on public issues. Writing about the technical and ethical dilemmas facing analysts, Hanna Segal states, "On the one hand, we must not collude with a patient's denial and idealization, just as we must not collude with the patient's denial of any other external situation that we may guess at from the material and that the patient does not bring out into the open. On the other hand, we must also be very wary of imposing on the patient our own preoccupations and convictions.