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This slim little book is a gem. It is clear, concise, and well written. With all the new, exciting developments in present-day psychoanalysis, in the maelstrom swirling around us of postmodernism, chaos theory, theories of gender, intersubjectivity, and narcissism, as well as the contributions of neurobiology, Rothstein reminds us of conflict, fantasy, and compromise formation, development and developmental calamities, anxiety and depressive affect. Few others could do this with such aplomb.
This is not a retrograde diatribe, but rather a useful guide to the therapeutic encounter. It is a modernist, evolutionary approach that incorporates new thinking without abandoning classical psychoanalysis.
The thesis, as laid out in the introduction, is the utility of the ideas of conflict, compromise formation, and fantasy. However, as one reads on, the focus is clearly on the interplay of the intersubjective with these basic ideas. Why it is set up in this way is a tantalizing question. Is it due to the author's deep grounding in and commitment to classical theory? Is it an effort to underline the importance of these basic concepts while noting and, at the same time, downplaying the prominence of intersubjective theory? Or is there some other reason? I leave it to the reader to ponder.
Clinical examples demonstrate the usefulness of understanding narcissism, sadomasochism, shame, and guilt as complex compromise formations. The central component of the compromise formation in the case of narcissism is a fantasy of perfection. Clinical material illustrates how these fantasies may be used defensively to reduce the unpleasure of the calamities of childhood.
Sadomasochism is derived from many factors and stages of development. Like narcissism, it exists along a spectrum with pathology at the extreme end. Considering this to be a complex compromise formation