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As our Guide through realms of traumatic devastation and shuddering darkness, Sue Grand takes us without hesitation into the consulting room to introduce us to “Alice.” Her preface creates a frightening immediacy, plunging the reader into an analyst's inner experience of toxic attack. Grand begins,
Alice's body stank, and with this stench she infected me. She lay on the couch, and its fabric absorbed her sweat. Reclusive and obese, she spoke of little else but of food, of body holes, of consuming and excreting, of
Page 730her mother's hostility and neglect, of an empty purse, of always being “dead broke.” It was winter, but when she was present I felt stifled in her sweat. Each session she wore the same polyester clothes; each session they appeared ever more soiled. It was as if she ate, slept, urinated, and defecated in the same clothes, day after day, week after week. I hated her body, and tried not to smell her. [p. xiii]
Alice steals from the dependent and needy elderly she is employed to care for; she steals money out of the analyst's coat hanging in the waiting room. Elsewhere in the book we meet a male nurse who sexually abuses his helpless charges before euthanizing them, and a woman who, knowing that her analyst is immune-compromised, comes to session in order to infect her with her flu.
What strikes the reader first is Grand's ability to survive exposure to such malignancy. The people she describes sitting with assault the senses, they bend and obliterate conventional reality, and most of all, many of them are so very cruel, teetering on the edge of inhumanity. Grand presents her clinical work with these patients with great candor and humility. She shows remarkable ability to engage clinically with countertransferential experiences that can only be described as experiences of terror.
An analyst in private practice in New York City, and a member of the relational faculty at New York University's Postdoctoral Program in Psychotherapy and Psychoanalysis, Grand resituat