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This edited collection of papers comes from the 12th annual British Object Relations Conference in Seattle in 2018. The papers focus primarily on the work of Winnicott, Bion and related object relations theorists, particularly Bion’s ideas about how mind makes meaning and thought out of primordial sensory-perceptual-somatic experience, and Winnicott’s ideas about the kind of undifferentiated maternal immersion and mirroring necessary to assist the infant in its primitive state to comprehend meaning itself. The authors attempt to apply these and other related concepts to their clinical experience with patients whose language does not express reflective thought but is dissociated from their basic experience and expression, which is somatic, affective and behavioural.
Providing unity, coherence and a sense of direction to an edited collection of papers is a problem. The editors have written introductions to each of its six sections; therefore 13 of the 19 chapters are original. Unfortunately, each chapter has a separate reference list, and the single index is relatively small. The undifferentiated, unintegrated, non-reflective somatic-behavioural mode that characterizes most of the patients described in the book is compatible with my understanding of psychosis, yet the index contains just four references to it, and none to the specific terms psychosis, psychotic or schizophrenic.
The authors are articulate, even poetic, and very knowledgeable on the aspects of object relations theory about which they write. The book explores a very important question; how can the analyst, functioning in reflective thought and language, relate in a mutative way to patients who function primarily in a non-reflective, concrete, enactive and somatic-affective mode. Most of the patients the authors describe are unable to think reflectively and do not suffer in the classical psychoanalytic sense of neurotic repression of mind in unconscious conflict. The language in which they understand thems