Editorial

The way in which a patient makes use of the clinical setting in individual practice is the concern of the first two papers in this issue of the Journal. How does the patient use the symbolic space and actual physicality of the consulting room? What kind of object is their therapist, at the outset, and as the work progresses? First of all, questions of entering into and leaving treatment pre-occupy Liza Catan, in ‘Panic and flight: claustro-agoraphobia in the consulting room’. Catan makes central use of the work of Henri Rey on a spatial conception of the mind, and specifically his formulation of claustro-agoraphobia-philia: ‘very primitive, oscillating states of mind’ in which patients ‘idealize places and situations where they are not’, with ‘palpable anxiety and continual flight between a range of alternatives’. She links this with Meltzer's claustrum as a ‘safe haven’ phantasized as providing protection from ‘the emotional pains of normal growth and individuation’. Catan rigorously focuses on the ‘beginning and ending of treatment for, while claustro-agoraphobia can break out at any point, its defining emotional reactions and behaviours tend to erupt with particular violence and clarity’ around beginning and leaving treament. In two complex, detailed vignettes, she reports on an initial consultation (after which the patient made no further contact) and a longer piece of work. Reflecting on the two cases, she links Rey's conceptualization with recent post-Kleinian theories of destructive narcissism and in particular the work of Britton on the conceptualization of psychic and material space.

Next, for Lorna Berger, in ‘Some thoughts on working with regression in psychoanalytic psychotherapy’, there is an unavoidable ‘spectre at the centre of the paper’, in that her account is inspired by an ongoing case about which she feels she can say little due to concerns about confidentiality. That said, the paper ranges over a group of themes that apply in a situation of thera