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Jonathan Sklar is a British psychoanalyst of the ‘Independent’ school, a training analyst and Fellow of the British Psychoanalytic Society who trained as a psychiatrist and was a consultant psychotherapist in the NHS. He brings a wealth of experience of work with severely disturbed and damaged patients to this collection of his papers covering over 25 years of work.
This is a book about atmosphere, tone, feeling-into and the need for listening long and painstakingly in analytic work. It is a book that will have particular resonance with analysts thinking about the implications of neuroscience and attachment in the understanding of trauma, even though Sklar's particular psychoanalytic position does not include these areas specifically. It could be argued that he doesn't need to and indeed that the growth of interest in these areas of clinical practice has arisen because of the neglect in contemporary psychoanalysis of the area he is focusing on: the relationship between real trauma and its manifestation as a kind of repetition in the consulting room in actions, tones, emotional currents, bodily states and changes, speech, transference, interpretation and perhaps most importantly allowing silence.
There are two theoretical descriptions from Freud that act as a compass for the reader (and, as Sklar describes so vividly, for the analyst when most lost). The primary one concerns the role of delusions when something traumatic has caused a split in the ego: ‘the delusion is found applied like a patch over the place where originally a rent had appeared in the ego's relation to the external world’ (Freud 1924, p. 151). Sklar notes that the original German word for the resulting split in the ego is Einreiss—a kind of tendency to tear—rather than Reiss, which is an actual tear. The tendency to tear means that something may be known and then not known; not knowing leaves behind it deeply buried knowledge that something has happened. The patch put over the gap does not cure the sp