Examining the Analyst at Work: A review of Psychoanalytic Collisions, by Joyce Anne Slochower. Mahwah, NJ:  The Analytic Press, 2006,  200 pp.

Joyce slochower is an excellent psychoanalytic writer. This book describes her evolution as a sensitive, self-reflective, thoughtful psychoanalytic clinician and writer. Focusing on the inevitable collisions between

opposing aims in analytic work—within ourselves and with our patients— she gets right down to what we find difficult in the treatment of more troubled patients. Her earlier writing made a valuable contribution to our appreciation of the moments when holding and containment facilitate therapeutic work by minimizing the patient's experience of the analyst's subjective presence (Slochower, 1991, 1992, 1996). I have found her work on the attunement to the analytic provision required by difficult patients very helpful in treating them. Of course, in our current psychoanalytic climate, some relationalists could object to what might appear as a challenge to the analyst's intersubjective involvement in therapeutic work, which it is not.

Slochower is helping us to think about what does and does not work most efficaciously with our most difficult patients. Sheldon Bach (2006) tackles similar problems admirably. Some analysts, not even Freudians, can keep insisting that interpretation is always the treatment for patients' distress. A number of analysts of different persuasions (Killingmo, 1989, 1995; Sanville, 1991; Rayner, 1992; Ghent, 1992, 1993; Meares, 1993; Meares and Anderson, 1993; ; Teicholz, 1995; Coen, 2005; Rustin, unpublished) have contended that interpretation intensifies separateness between patient and analyst, which is not what more difficult patients need at the start of treatment. Rather, these authors advise that difficult patients need to feel the analyst's matching, attunement, holding, and affirmation sufficiently—now regarded as legitimate analytic functions—before the analyst can interpret.1,2

I admire Slochower's openness, honesty, and forthrightness in examining her own clinical work. You know she is an excellent clinical analyst as you re