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This book is subtitled Pathological Organizations in Psychotic, Neurotic and Borderline Patients. The author tells us at the start that his concern is primarily clinical: ‘My central preoccupation is the way organizations function in individual patients in individual sessions during an analysis’. This is the strength of the book.
What Steiner calls the pathological organisation has a long history which he traces back to Freud, Abraham, and more recent writers such as Joan Riviere, Rosenfeld, Segal and Joseph. He argues that such an organisation is connected with primitive destructiveness and cites Freud's remark that there can be obstacles to change running so deep that we have to assume the operation of the death instinct . Violence or neglect in the environment may result in the internalisation of violent disturbed objects which in turn become ‘receptacles for the projection of the individual's own destructiveness’. Steiner draws on the work of Klein and others, including Bion's ideas on violent splitting and projection.
The emphasis is on organisation, as in Rosenfeld's dramatic description, in his paper of 1971, of the mafia gang. Following Klein , Steiner proposes that the organisation is experienced by the patient as a retreat, a relatively anxiety-free state, situated between the paranoid schizoid and the depressive positions, a kind of siding or layby. The technical problems facing the analyst are, first, the stuckness of the situation and, second, the lure of the organisation, where peace from anxiety and guilt is bought at the price of complicity, so that the analyst has to ‘struggle with his own propensity both to fit in and collude with the organisation on the one hand, and to withdraw into his own defensive retreat on the other’. The book is full of examples of sequences from sessions illustrating these difficulties, and Steiner is refreshingly frank about mistakes and failures.
A fair amount of the material of this book has already been published in vario