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This book intrigues. It describes excellently in transparent detail the clinical work of the author. Judith Mitrani is a Los Angeles psychoanalyst; trained there as a Kleinian she uses British psychoanalytic ideas of the Kleinian and object relations schools (Bick, Meltzer, Tustin as well as Winnicott). Thus she explores the use of Kleinian and so-called post-Kleinian concepts within the American psychoanalytic culture, dominated by ego-psychology and its derivatives. Mitrani does not work ‘within’ the ego-psychology tradition, but nevertheless there are traces of her argument that suggest an enduring need in California to emphasise differences - for instance the stress on anxiety rather than defences, and on the interpretation of transference. One interest for me in reviewing this book is the question: how do Kleinian views fare when transplanted into another psychoanalytic environment?
The book is full of clinical detail and process records of the author's work, which turn around two main cases, Hendrick and Chloe. As the author says it is a description of how one psychoanalyst works. But it is also an account of the theoretical developments that have led her to work in the way she does. Thus the book has more than one theme. In fact I think there are three - first, the theoretical developments that lead from Klein via Bick and Meltzer to Tustin; second, the clinical process that derives from the notion of transference as the total situation, described by Klein (1952) and Joseph (1985); and, third, the inspirational supervision and friendship with Frances Tustin. As a backdrop to these themes is Mitrani's deep acknowledgement of Bion's ideas (especially the later papers). This is a unique blend, one which the author has worked hard to integrate, and in addition has worked hard to present to her readers. The overriding quality of this book is its transparency, its lucid quality of discourse about the author's work, and the clear presentation of the clinical process