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Ved Mehta, the Nobel prize-winning author, gave four principles for good writing: clarity, harmony, truth and an unflinching courtesy to the reader. Peter Giovacchini follows these principles in his latest book, Impact of Narcissism: the Errant Therapist on A Chaotic Quest.
This book is actually two books woven into one. First, Giovacchini writes clearly about clinical work with the narcissistic component of character disorders. Like Freud, he punctuates narrative by clinical material. Second, and a more challenging task, he writes of the jeopardy to our discipline when we become narcissistically invested in our theories over our patients' needs.
Kuhn emphasized the essential tension between daily normative science and periodic paradigmatic discoveries (Archimedes' “Eureka!”). Giovacchini encourages us to use our theoretical ears to listen to patients, yet use our scientific curiosity and thinking to challenge our theories when patients challenge us. Dora did this to Freud; we should follow suit.
This volume also gives a remarkably crisp summary of major psychoanalytic theories; a cry for not inventing neologisms when previous terms, such as the transference/countertransference axis, serves well; explorations of how countertransferences can be along a benign/malignant axis; relating the countertransference to the ego-ideal, the superego; and an exploration of the continuum of narcissism from psychopathology to how it contributes to self-esteem and creativity.
Let us return to perhaps the more unsettling theme of Giovacchini's book: how narcissism in our profession has jeopardized our credibility, or at least, through hero-worship, hindered the development of our science and technique.
Frattaroli wrote how Freud was both heterodox and orthodox with his own ideas. Internecine warfare began when his acolytes could become either “orthodox” (Jones, Strachey, Anna Freud) or “heterodox” (Jung, Adler, perhaps even the beloved Ferenczi). But, Giovacchini, in a chapter entitled “O