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It should be said at the outset: this is a brilliant psychoanalytic book, not only for its content but for the style of its writing. Open this book at any page, and you will find an insight and a description that will inform you about clinical choices, reason with you in a considered and careful manner, and frankly delight you with its passion and empathy. This is the kind of book that will become frayed in my library, from picking it up again and again, for at every point it makes one say “I recognize this patient or this situation and Bach makes me ponder and wonder anew about it.”
For this review, I am tempted to just selectively quote Bach from his thirteen papers here, without comment, because there is so much that is profound. The thirteen papers range from titles such as “On the Narcissistic State of Consciousness” to “Sadomasochism in Clinical Practice and Everyday Life” to “On Treating the Difficult Patient” to “Analytic Technique and Analytic Love.” But there are two common themes, among many, that stand out in all these collected papers. The first is embodied in Bach’s statement that, “If we are only able to listen carefully enough, patients will usually prescribe exactly what is necessary for their healing to begin” (p. 224).
This statement occurs in a discussion of a difficult concrete patient (in a chapter entitled “On Treating the Difficult Patient”) who near the beginning of her therapy, contemplates leaving treatment after the therapist’s separation from her for an extended weekend vacation,
having gone to a psychic in the meantime who gives her a piece of a rock that makes her feel “more calm and secure” (p. 222). The patient had a history of attaching herself to older men—father figures—and then leaving precipitously when the relationship became too close. But an interpretation of this by her male therapist did not diminish her intention to head for the door. Only when the therapist introduced the fact that the patient’s mother (who rarely touche