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This very valuable collection of essays by the masterful contemporary Kleinian theoretician and clinician John Steiner presents his continued reflections on analytic work with patients whose extreme narcissistic vulnerabilities
lead to a position of psychic immobility, which he previously described in his book Psychic Retreats.1 In his earlier work, Steiner used the spatial metaphor of a psychic retreat as a way of conceptualizing the structural consequences of the complex pathological organization of defenses and compromised object relations that certain individuals develop to withdraw from tremendously painful experiences of paranoid and depressive anxiety. This position of retreat results in severe resistance to development and change in analytic work with such patients, leading often to impasse and stasis.
In his current book of essays, Steiner continues to develop and elaborate a contemporary Kleinian approach to resistance, as he extends his metaphor of psychic retreat to the fantasied dangers of seeing and being seen that such patients must confront as they attempt to emerge from their psychic hiding places. Steiner states that his major new focus in this book is on the affects of embarrassment, shame, and humiliation, and their associated fantasied object relations, which have previously been relatively neglected within Kleinian theorizing. He examines how these affects can lead to struggles for power and dominance within the transference, or to defensive clinging to resentment and revenge. In particular, Steiner emphasizes the uniquely unbearable quality of shame and humiliation that demands immediate relief. Failure to address the peremptory nature of these affects can block therapeutic movement toward the more traditional domain of Kleinian work, the anxieties of the depressive position, and the need to face loss and mourning.
Despite the author's articulated focus, the essays gathered in this collection—originally presented or published between 1996 and