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A small paperback of clinical notes by a rara avis: a family doctor who is also a practising Kleinian psychoanalyst.
Even today among some Independent and Classical Members of the British Psycho-Analytical Society, the Kleinians still tend to un-enjoy the reputation of disregarding external reality in favour of internal fantasy. Sanders' series of vignettes will go some way in refuting this assertion both at home and among the international psychoanalytic community.
The author is a single-handed (I think this is important), family doctor working within the British National Health Service, which means that he is paid on a capitation basis and not for each individual service performed: his sense of empathy, compassion and identification that is manifested with, and for the patient, evokes descriptions of physical suffering in the underpriviledged by, say, Cronin, Maugham and Graham Green.
Psychoanalysis, like some other clinical occupations, can be used as a defence, a barrier between its practitioners and the affects of those seeking help. Sanders is no General or Field Marshall sitting behind a couch; he uses his speciality in the front line, suffering with, and for the troops: his patients, who he sees in his office, in their homes and especially at their bedsides.
The little essays entice with headings such as 'On Being Unable to Weep'; 'Infantile Asthma: containing the Anxiety'; 'On the Brink'; 'The Lady with the Miniatures'; 'Adolescent Confusion', among others. There is a chapter referring to the work of Sanders' mentors, Bion and Meltzer, whose concepts, as well as those of other analysts, are conveyed to his general practice patients in a form both meaningful and comforting. The account, besides conceptualizing a link between physical illness and metapsychology, is also a social document of life in Britain in 1987 where the gap between rich and poor is widening.
The book is indeed 'A Matter of Interest' ; it should be read by analysts and non-analysts, by