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In this work, whose English title would be Agony, Splitting, and Sym-bolization, René Roussillon develops his theoretical elaboration of the clinical manifestations of narcissistic identity disorders or, more specifically, the transferential expressions of identity disorders and
narcissistic disorders of self-regulation. He examines these patients' difficulties with the symbolization of their personal history and, consequently, their problems with the subjective appropriation of relevant aspects of instinctual life, narcissism, and object relations. The fifteen chapters include rewritten versions of twelve texts published during the last ten years, as well as three new texts, including a thorough introduction that provides an excellent overview of the book. Roussillon proposes a theoretical-clinical model delineating the sequence of psychic processes typical of narcissistic identity disorders. The main assumption guiding his approach is that suffering in connection with these pathologies is the result of a specific defensive structure established to fend off the impact of a split-off primary trauma which, through the repetition compulsion, continues to threaten the organization of the psyche and the development of subjectivity.
In the book's first part (“Agony and Splitting”), Roussillon presents his conception of primary trauma, an extension of the trauma model developed by Freud in 1920 in Beyond the Pleasure Principle. As Roussillon explains, primary trauma occurs when the experience of self in relation to the object cannot be represented or symbolized; therefore, in order to survive an unbearable and nonintegrable experience, the subject has no recourse but to withdraw from itself. In consequence of having split off a part of itself that is essential to its identity, the subject is left in a state of depletion (en manque de soi). Roussillon is particularly interested in the disorganizing consequences of a traumatic breaching of the self, where binding capacitie