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Peter Giovacchini has devoted his career to finding effective ways to work with patients suffering from pathological narcissism. Modern psychoanalysts and students of modern psychoanalysis will benefit from a careful reading of this book, in which he provides an overview of his life work, and a summative presentation both of his approach to patients and of his principal ideas about narcissism. Modern psychoanalytic readers may find much to challenge or disagree with, but they will also find much that is thought provoking, suggestive, clinically useful, and at certain points convergent with modern psychoanalysis. There is indeed an uneven quality to the book, which may at first challenge the reader's desire to persevere. It contains some autobiographical material, which helps situate the author's developing views about narcissism within a context of clinical experience, which he then attempts to place within a broader cultural and historical framework. It contains some very strong criticism of some of the innovations in psychoanalytic theory and practice, which have been developed to address the difficulties of treating narcissistic patients. A particular target of criticism is self psychology, and indeed Kohut himself, The book contains also some excellent discussion of the relations between narcissism and countertransference, and of the ways that countertrans-ference can be employed effectively in the treatment of narcissistic