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Dr H. A. Rosenfeld died in 1986 after a sudden and short illness at the age of 76. He had completed his work on this book but he did not live to see its publication. It contains the reflections of his last years on the topic at the centre of his professional life – the psychoanalysis of psychosis.
Rosenfeld came to Britain from Nazi Germany in 1935. After retaking his medical examinations he trained as a psychotherapist at the Tavistock Clinic, working meanwhile at the Maudsley and a hospital in Oxfordshire with psychotic patients. In 1942 he began his psychoanalytic training at the Institute and began also an analysis with Melanie Klein. His analysis was, in his own phrase, ‘a revelation’. In relation to his work, it confirmed the general view he himself had formed, viz., psychotic patients respond to understanding. Melanie Klein’s findings about the ego’s relations to its early objects and its defences against primitive anxieties with a psychotic content then suddenly gave Dr Rosenfeld the means with which to try to analyse psychosis.
In 1947 his first famous paper, ‘Analysis of a Schizophrenic State with Depersonalization’, appeared, the first published account of an adult psychotic treated by psychoanalysis. Further brilliant papers followed, collected in 1965 in a volume called Psychotic States, a book widely admired as a pioneering investigation into the nature of, and the psychoanalytic treatment of, the psychoses.
The book under review continues Dr Rosenfeld’s interest in the psychoses, but in a different way. Where the clinical evidence for the scientific papers in Psychotic States was his own analytic work with very ill patients, Impasse and Interpretation rests mainly on supervisory and seminar discussions of the clinical reports of other analysts and therapists whose cases have reached an impasse. The result is a work much looser in its connections and conclusions. Rather than offering compelling scientific evidence, it is more in the nature of an assemb