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Marilia Aisenstein, a central figure in French psychoanalysis, and the Paris Psychosomatic School, has written a gem of a book. It is a master class in how Freud’s thinking enriches us, while opening new pathways for thinking about certain patients (psychosomatic), and those who seem to have little or no imaginative thinking. Along with all one can learn from this book, what sets it apart is that it is a pleasure to read due to Dr. Aisenstein’s clear thinking, the beauty of her language, and her use of metaphor.
As the title suggests, the book is a selection of Dr. Aisenstein’s papers from 1992 to the present. These include papers on: the history of psychoanalysis in Paris and the Paris Psychosomatic School; psychoanalytic technique with an emphasis on working with patients with psychosomatic disorders that add insight into working with patients who cannot think their thoughts; what it means to become a psychoanalyst; the development of sexual identity, and other contributions. It is filled with clinical examples that demonstrate her humanity, and the efficacy of her theoretical positions.
The heart of Dr. Aisenstein’s clinical perspective, and most edifying, is her view that thinking is “rooted in the drive” (p. 49), especially Freud’s dual drive theory from Beyond the Pleasure Principle.† Her thinking this way is evident throughout the book, and time after time one sees how a true Freud scholar can, in a few pages, show the history of an idea. In addition, Dr. Aisenstein emphasizes the importance of bringing buried affect associated with traumatic memories to preconscious awareness.
The shift of accent from representation to affect has considerable clinical implications. Indeed, with certain patients, including (though not exclusively) somatic patients, the entire work of analysis will now be centered on gaining access to affects and on their metabolisation. [p. 60]
This doesn’t mean that Dr. Aisenstein eschews representations, as indicated by the following: “Putti