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The work of Betty Joseph, along with that of Bion, Rosenfeld and Segal, has profoundly, though in her case perhaps rather quietly, influenced a new generation of Kleinian psychoanalysts. With them she has developed and extended Klein's concept of projective identification and its implications for analytic thinking about the use of transference and counter-transference in clinical practice.
Joseph's distinctive contribution lies in her unflinching interest and openness to the most daunting and apparently intractable clinical dilemmas, in which the patient seems emotionally inaccessible and the analysis fails to progress, and in her refinement of a technique which, she argues, offers the analyst more hope of making meaningful contact with the patient.
In Joseph's vivid and sensitive evocation of the clinical situation the reader, whatever his theoretical orientation, will recognise himself and his patients, and the struggles they are engaged in to understand and remain in contact with painful experience. Kleinian, or non-Kleinian, one cannot, I believe, fail to feel helped by her approach to take a fresh look at one's work.
The book is divided into four sections, ‘Beginnings’, ‘Breakthrough’, ‘Consolidation’ and ‘Recent Developments’, each containing several papers presented in the order in which they were written and representing stages in the evolution of Joseph's ideas.
In their introductions the editors, Spillius and Feldman, help the reader to trace the development of Joseph's ideas and to identify the major themes which constitute her unique contribution to modern psycho-analytic practice. These they outline as:
The patient's need to maintain his or her existing psychic equilibrium despite the conscious wish to change
Psychic change and the forces which promote or militate against it
The evolution of a technique which takes account of the above, described by the editors as the attempt to provide, within the analytic setting:
a precise working out of the way the patient'