Affect intolerance in patient and analyst By Stanley Coen. Northvale, NJ and London. Pp.  290. 1st edn. 2002.

Stanley Coen writes as I imagine he works as an analyst—personally, directly, engagingly. He is not the distant, omniscient theorist-clinician that we encounter so often in the first century of psychoanalytic writing. Coen is a real person, telling us about his (and our) struggles with tough patients—his feelings, mistakes, consultations, disagreements—all with a tone of good sense and a willingness to reconsider. Perhaps disconcerting to the student who would like authoritative statements, but for therapists and analysts who have ‘been there’, Coen's new volume, Affect intolerance in patient and analyst, has the ring of truth.

Coen's mission is the exploration of how and why the partners in the analytic dyad evade knowing and discussing their feelings. In the spirit of our increasingly democratic psychoanalytic times, he considers the analyst's affects and defences against affects alongside those of the patient. Inevitably, this bilateral focus takes Coen into discussions of countertransference, relational theories and technical issues of self-revelation. He challenges us to discuss these controversial themes openly, without finger pointing and dismissiveness. Acknowledging his origins as a ‘traditional’ analyst—meaning American ego-psychological, given his training at the Columbia Institute in New York City—Coen looks for additional help in other points of view. In the work he describes in this volume, much of it involving patients with serious character difficulties, he finds help in contemporary Kleinians as well as contemporary Freudians and intersubjectivists. More to the point, Coen often takes us with him to meetings and seminars where he presents the cases he talks about in the book. We hear both the comments of specific analytic discussants and Coen's reactions to them. We hear Coen reacting to case presentations by others, noting their ability to tolerate the patient's or their own affects, and to work with feelings in the process. It is this sort of ‘You