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Juan Gennaro's new book, In the Defiles of the Psyche, is an extraordinary, at times breathtaking, anthology of clinical cases, the product of a psychoanalytic work life, in which the reader witnesses the encounter between Gennaro and his patients.
The book's title is an apt, polysemic metaphor for the encounter between Gennaro and his patients. A defile is a narrow passage, an intermediate space, a gap, here between analyst and patient. A defile is a narrow canyon, a gorge, a trail between walls allowing “transferential movements.”
The first part of the book, “First Steps: In the Defiles of the Abyss,” a psychoanalytic reflection on the fundamental causes and dramatic scenarios in which psychosis develops, presents in detail the clinical cases of seven psychotic patients at l'Eau Vive, a French psychiatric hospital. Influenced by Gisela Pankow and D. W. Winnicott, and aiming to repair his patients’ fragmented selves, Gennaro invites them to model with clay, thus creating a transitional creative space. Modeling with clay achieves at least two goals: on one hand, it presents a dimension of reality, a concrete space, while on the other it suggests the disorganized internal world of the patient, governed principally by the primary process.
The second part of the book, “On the Pathway,” is a detailed presentation of six clinical cases. (Gennaro had at this point left l'Eau Vive.) The titles of these clinical cases gives the reader an idea of Gennaro's incisive interest in his clinical work, and of his intellectual thoroughness in exploring theoretical conceptualizations. Here are four: “Fragmentation and Integration of the Oedipal Conflict”; “Reflections on Paternity and the Wish to Be a Father”; “A Case of Lasthénie de Ferjol Syndrome”; and “Play in Psychoanalysis with Children.”
While Gennaro's notion of transference points to Freud's second topography, it also includes some contemporary psychoanalytic approaches. It is this consolidation of ideas from classical and co