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Bernd Nissen’s book about nameless states systematically addresses one of the most challenging questions in psychoanalytic theory and practice. It can be regarded as a common point of view in psychoanalytic research that the symbolic unconscious described by Freud does not sufficiently describe the structure and dynamics we encounter in our work with severely disturbed patients. Nissen chooses the label of nameless states to describe these formations outside the unconscious structures that he calls repressed unconscious to indicate that we are no longer dealing with unconscious structures characterized by condensation, displacement, projection, or repression—in other words, the defense-mechanisms described by Freud. Talking of nameless states also makes clear that Nissen is rooted in a Bionian tradition, and in fact Bion is the main reference in Nissen book.
The book has two parts. In the first, Nissen’s concept of nameless states is developed. In the second, Nissen’s ideas of the principles of treatment are depicted and enriched by clear and deeply understood case reports. In both parts, Nissen is admirably clear in what he says and courageous in the way he steps out of the common sense of today’s psychoanalytic ideas about the treatment of severely disturbed patients. To go right to the center of the challenge that Nissen’s book presents for the psychoanalytic community, it can be said that the author does not share the conviction that projective identification, and its being worked through in the countertransference of the analyst, is the via regia for the treatment to patients suffering from nameless states. Since I share this conviction, I am grateful for the clarity and decisiveness with which Nissen develops this point.