Introduction

In this book I continue to explore the themes developed in Psychic Retreats (1993), especially those that appear from a consideration of clinical situations where patients feel stuck and where a failure to develop impedes the progress of the analysis. As in my previous works, my starting point is the recognition that we all need defences to protect us from anxiety and pain. The aim of analysis is not to remove the patient’s defences but to understand them and through such understanding gradually to help the patient recognise new possibilities and potentials.

Progress is often marred when defences that are no longer necessary continue to be deployed because the patient is afraid of losing the protection they provide and is uncertain about alternative ways of coping with anxiety and pain. Looking at the anxieties that arise as the patient begins to let go of defences can help us to understand his(1) dependence on them. However, it is also important to understand that defences are sometimes held on to with great tenacity and are most resistant to change when they form an organised and coordinated structure. Our understanding of the basic form and function of these organisations has been greatly enhanced by recent analytic work, some of which is reviewed in my earlier book (Steiner, 1993), where I describe these systems of defences as pathological organisations of the personality and the structures they give rise to as psychic retreats.

The present volume comprises a selection of more recent papers that seem to me to share a common theme. In Part One, I discuss the importance of the experiences of embarrassment, shame, and

humiliation that confront the individual who begins to relinquish a narcissistic organisation and to emerge from a psychic retreat. In Part Two I describe a hierarchy o