One gets the feeling after reading this book that Otto Kernberg has never had an idle moment in his 82 years on this earth to date. The sheer depth and breadth of his theoretical and clinical oeuvre as a psychiatrist working within the psychoanalytic domain is astonishing; and what he describes as his ‘recent work’ is gathered together in this substantial collection of (mainly) previously published journal articles and book chapters. A fair amount of it is predictable for those familiar with Kernberg: in particular, updated approaches to diagnosis and treatment of the most severe personality disorders, especially the spectrum of severe narcissistic psychopathology, in the United States. This includes a useful detailed case utilizing the transference-focused psychoanalytic psychotherapy which was developed by Kernberg and has repeatedly empirically demonstrated its efficacy. But it is the more unexpected aspects of this