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If a patient leaves after her first session and never returns to treatment, does that constitute a failure? What of the patient who establishes a deep connection and stays in treatment for a decade without making noticeable changes in his everyday life? Is it a treatment failure when a patient comes to analysis with the aspiration of eliminating a sexual perversion, and leaves analysis with a marked change in self-esteem and depth of relationships, but with the perversion now an accepted, ego-syntonic aspect of her identity? In The Analysis of Failure, Arnold Goldberg digs deeply into questions of this nature, with a close examination of them through clinical vignettes.
Before opening the book's cover, I had a fantasy about what I might find inside. True to the culture of reality television, where we can watch formerly successful and famous people decompensate in their living rooms, or cheer on “common” folks as they rise to idolatry, I imagined a Roger Ebert-style process of judgment: “I give this treatment two thumbs down!” What I found instead was a tremendous effort for balance, openness, and dialogue about the very polarity of success/failure, and the multiplicity of angles on how such judgments can be framed.
Goldberg is, of course, a self-avowed self psychologist, and he reminds us that there is a special place for concepts like failure, as in empathic failure, in his theory of technique. To Goldberg, failure on a smaller scale is inevitable, and though it is not to be intentionally enacted, an openness and self-reflection about the moments of rupture in a treatment can be the engine that moves clinical work forward. With this vantage point, he is in a position to be extremely empathic with failures of clinicians of all stripes, and one of the clearest take-home messages that pervades this book is a call for clinicians of varying treatment