Book Review Essay: Extending the Boundaries of Psychopathology and of its Psychoanalytic Treatment: A Review of Engaging Primitive Anxieties of the Emerging Self: The Legacy of Frances Tustin, Edited by B. Levine and D. G. Power. London: Karnac, 2017. 270 pp.

This is an important collection. It is both encyclopaedic and scholarly in its willingness to address a multitude of theoretical and technical implications of the efforts to treat extremely severe levels of psychopathology and/or underdevelopment by the psychoanalytic method. It builds a helpful bridge between child and adult psychoanalytic theory. The existence of “unrepresented states” appears to challenge the fundamental credo of psychoanalysis, that psychological states are full of meaning (Fairbairn 1952; Levine et al. 2013). Yet there are some wonderfully moving clinical accounts of the patients’ moves through, and eventually beyond, the unrepresented and unintegrated states behind autism, and then beyond the autistic state itself. The contributors describe black

holes, voids, lack of hope of a container, lack of ownership of one’s body, lack of volition over one’s mouth, emptiness, and above all, formlessness and unintegration. Eshel’s very perverse masochistic and fetishistic patient was finally able to give up his perversion but then felt that he was confused and lost in utter emptiness, with no tools and no equipment to help him in t