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In this book René Roussillon continues the process that he started in Paradoxes et situations limites de la psychanalyse (Paradoxes and borderline states in psychoanalysis), a remarkable book published by in 1991. Roussillon elaborates and explores in more detail the many clinical and theoretical developments presented there—for example, with a set of brilliant reflections on Winnicott's work.
In the course of various clinical studies Roussillon puts forward ‘a model for understanding the narcissistic sufferings and forms of defence (splittings, somatic bindings, perverse masochism, fetishism etc.) that the psyche sets up in order to suppress the catastrophic return of the agonistic experiences that underlie them’ (p. 4). This book also proposes ‘a model for the splitting that operates in these extreme situations of subjectivity, leading on to technical questions about the treatment of these pathologies’ (p. 4). Finally, on the basis of a consideration of the symbolising function of primary objects—a function that is weak in these cases—a model of primary symbolisation is put forward that completes the traditional concept of symbolisation.
The book therefore presents a unitary model of the process at work in the different forms of narcissistic pathology; this is an alternative and complementary one to Freud's model of neurotic suffering. The model proposed here is based on the hypothesis of an organisation defending itself against the effects of split-off primary trauma and the threat that this trauma continues to pose to the psychic organisation through the repetition compulsion.
In Freud's well-known model of neurosis, the present-day conflict resonates with a historic one connected with infantile sexuality that at the time it was only possible to repress. The