You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
In this book, the author demonstrates his capacities as a scholar, a researcher, and a Renaissance man. But above all, he is a clinician, and his ambition is to explore and expand our thinking about the essentials in achieving successful therapeutic action. His point of departure is his recognition that Kohut, while positing that archaic narcissism is transformed through empathy, humor, creativity, and a sense of transience and wisdom, did not provide many details as to how these transformations might occur.1
Lachmann's three principles of the “how” of therapeutic transformations are: (1) “ongoing regulations” occurring in the process of analytic interactions, (2) disruptions and subsequent repair, and (3) heightened affective moments that are both inevitable and essential to effect change. While the first two of these are part of all psychoanalytic treatment, it is the role of affects—the process of transforming them as they are engaged in the analytic relationship, and their ultimate impact on altering self pathology—that receives most of Lachmann's emphasis. He undertakes a further exploration of character pathology, of expectations and their violation, and of the roles of humor, creativity, and empathy in treatment. These themes are introduced in the book's early chapters, illuminated by clinical illustrations, and are ultimately pulled together in the later chapters.
As Lachmann lays the foundation of his thesis, he utilizes findings from infant research and contemporary cultural life to enliven and educate. He ranges into the world of boxing to comment on mutual attunement