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This book, writes Judith Mitrani, is an account of one analyst's way of doing things. It is a beautifully written account, organized with great conceptual clarity and richly illustrated with detailed reports of clinical work. The sub-title of the book is ‘A post-Kleinian approach to the treatment of primitive mental states’, and indeed all the patients described invoked ‘extra-ordinary protections’ in an attempt to deal with overwhelming fears. These fears were often experienced in bodily terms: a patient talks about having a bit missing from his head and a hole in his body, like his baby sister who was left with an aunt and died in an institution. One of the book's main themes concerns the processes between patient and analyst by which experiences of this kind can be made thinkable, instead of being evacuated, projected or encapsulated. This theme figured importantly in Mitrani's (1996) earlier book, A Framework for the Imaginary, as it did in her paper on psychosomatic asthma (Mitrani, 1993) in which she introduced the term ‘unmentalized experience’.
Mitrani came to Klein's work through a professor of literature at the University of California, who thought that it would add a dimension to his students’ understanding of the ‘dark writings’ of Dostoevski, Tolstoi and others. She writes that her first analysis, while ‘perhaps classical by London standards, was anything but dogmatic and gave me the leeway to know what I thought’. She read widely in British psychoanalysis, including the work of