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This is an informative book, written knowledgeably and with an economy of words. It impresses the reader as the work of a wise man reflecting upon and consolidating many years of effort in a field that he loves and practises with vitality. It is certainly a continuation of Bach's thinking from earlier works (Bach and Schwartz, 1972; Bach, 1977, 1985, 1994). It is about the teachers who enriched and encouraged his work (David Rapaport, Robert Holt and George Klein, to name but a few) and the institution where they met and thrived: the New York University's Research Center for Mental Health. As such it is a testament to 40 years of collaborative friendships within a study group. The book shows clearly the evolution of Bach's thinking about the treatment of difficult and suffering patients – the group of patients to whom he has made a lifelong commitment.
Getting from Here to There is fundamentally about the way transitions are difficult for many patients who use splitting as a defence against separation and the awareness of being dependent and alone. The transitions are apparent in several ways and contexts: changing one's mind, moving from one state of mind to another, the inability to use transitional phenomena to ease these transitions, an either–or mentality where choice is rendered impossible because of an inability to move from split good and bad objects to consolidated ambivalent objects that can facilitate and enable the needed change. The splitting can be seen in the roles people unconsciously assume when they have grown up with parents who lack knowledge of their children but insistently demand of them a particular behaviour, state of mind, or enactment. The situation Bach describes is more than just a psychic log jam; it reflects a paralysis of mental functioning, a stable un-integration. Originating in a failure to establish basic trust during childhood, it poses the need for the therapeutic creation of ‘analytic trust’ (Ellman, 1998).
Incorporating ideas fr