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Gender, sexuality, femininity and body image have received considerable attention in the psychoanalytic literature in recent years. Most of this writing, however, including thoughtful and historically inclusive psychoanalytic articles (e.g. Dimen and Goldner, 2012) do not consider the actual biological body. This neglect can be understood in part as a reflection of the theoretical shifts from classical drive theory to postmodern concepts which emphasize the social construction of gender, the influence of the mind on concepts of the body and the ambiguity of terms such as ‘femininity’. The female body is even more absent from the literature and the pregnant body hardly appears at all. Balsam, in this unusual, beautifully written book, goes a long way to address this absence and its impact on psychoanalytic theory and practice. The book is based on careful scholarship, a thoughtful examination of theory, and detailed clinical observation. Its language is wonderfully rich, clear and evocative. She considers the reasons for the omission of the body, and examines the effects of this lacuna on analysts' understanding of their patients. She observes that even those psychoanalysts who have written about the female body (e.g. Pines, 1993; Raphael-Leff, 1991) have not integrated their observations into psychoanalytic theory. She believes there is a need to include consideration of the sexed gendered body in all phases of development and to integrate this knowledge into psychoanalytic theory. Her book is ground-breaking in combining a complex consideration of three related topics which are not usually considered together nor in such depth: gender, the female body and the uniquely female activity of pregnancy.
Balsam's descriptions of clinical psychoanalytic hours in which her observations and interpretations are based on attention to the woman patient's feelings and thoughts about her own body, her memories and fantasies of her mother's and other women's bodies, and her relatio