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David Rosenfeld is a psychoanalyst practising in Buenos Aires, familiar with the works of Shakespeare from which he gives numerous quotations. His clinical approach is based on British object-realations theory and on a rigorous use of transference and countertransference. Throughout his book he describes very generously a vast amount of clinical material he has gathered as a therapist and as a supervisor. I appreciated the microscopic level at which he deals with such material, including the detailed transcript of analytic sessions, with the exact words spoken by both therapist and patient. He is concerned with the more disturbed end of the spectrum of psychopathology accountable for psychotic states or for psychotic parts of the personality. He shows how psychotic psychopathological mechanisms underlie a variety of conditions regarded as non-psychotic according to conventional psychiatric criteria. In this way, psychoanalysis broadens the psychiatric concept of psychosis. Under the same umbrella he describes cases of psychosis, drug addiction, psychosomatic disorders, hypochondrias, impulsive personalities, sexual perversions, survivors of the Nazi holocaust and others.
According to Rosenfeld, Freud's concept of the splitting of the ego into a normal part and another part that detaches the ego from reality is of fundamental importance. As a consequence two psychic attitudes are formed instead of a single one - one normal and another psychotic.
For Rosenfeld countertransference is the via regia to the investigation of the psychoses, just as dreams can be to the investigation of neuroses. The analyst needs to think about his countertransference and decode it if he is to understand what a psychotic patient cannot express with words. He needs to be aware of the structure of the language used by the patient viewed as a reflection of a concomitant thinking activity. Often he needs to wait for a long time before giving an interpretation which will take into account both the