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As I embarked on reading this selection of past papers by Margaret Rustin, I set about it in the way I have often used in book reviews—copying particularly inspiring or insightful phrases into a document so I could refer to them or quote them in the review to come. Before I had got very far into the book, I realized that I was rapidly accumulating a huge collection of beautiful examples of observational acuity, thoughtful analysis, deep empathy and wisdom. My document was becoming full and lengthy—I was in danger of copying and pasting most of the book! The emphasis moved to being on what to leave out rather than what to include. I will endeavour in this review to capture what seem to be the most valuable contributions but am aware that I will not be able to do it justice.
Rustin manages in every part of this book to demonstrate her capacity to ‘integrate feeling and thinking’ in a way that facilitates a deep and compassionate engagement with all her patients and their parents, carers and professional networks. She has so much to offer, yet never seems to lose her sense that it is she who has the ‘privilege of undertaking clinical work with children and adolescents’ (p. xiv) from which she goes on learning during decades of practice.
As some of the psychoanalytic world still struggles to give due weight to psychosocial factors in our patients’ difficulties, Rustin presents us with both a straightforwardly sensible and a subtle awareness of the complexity of the interactions between a child's internal world and their external world. She is consistently and impressively even-handed in her appreciation both of the damage parents can do to their children and the intense pressures on families and the unprocessed pain and anxiety which constrict the parents’ capacity for care and love. Likewise, she has some powerful comments to make about the failings in social care, fostering arrangements and residential units, but always tempers these with a countervailing empathy with t