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Gerard Fromm has written a clinically wise and engaging book that explicates the implications and applications of Winnicott's thinking to work with
our most disturbed patients. The title, Taking the transference, embodies Fromm's core thesis: the analyst must be able to ‘take’, that is, tolerate and hold, the intense transference feelings that very ill patients bring to the consulting room.
This is a deeply phenomenological, non-polemical book, rich with complex case illustrations and thickened with Fromm's creative use of theory. It will engage a range of readers, from beginning therapists struggling with their most disturbed patients, to seasoned clinicians interested in expanding the relevance of Winnicottian ideas to borderline and psychotic patients.
Much of Fromm's clinical material is taken from patients seen at the Austen Riggs Center in Massachusetts. Riggs is an unusual - and impressive - treatment setting. In an open (non-coercive) therapeutic community, very disturbed patients receive treatment in individual psychoanalytic psychotherapy along with other community-based modalities.
Many of the patients Fromm describes would be diagnosed as borderline or psychotic. But Fromm challenges the usefulness of these categories and formulates clinical dynamics outside them. Fromm uses detailed case material to illustrate how the therapist can help very ill patients work through the kind of deep transference involvement that we more typically associate with intensive on-the-couch psychoanalytic treatment of neurotic patients. Implicitly, Fromm challenges those readers committed to ideas of ‘analyzability’ to rethink these categories.
Each of the 13 chapters takes up a different clinical/theoretical issue. Two explicitly discuss (and challenge) aspects of standard diagnosis - “What does borderline mean” (Chapter 2) and “Psychosis, trauma, and the speechless content” (Chapter 10). While issues of technique are central throughout the book, two chapters focus on Fromm's