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Jill Montgomery and Ann Greif have brought together a collection of well-written and powerful clinical vignettes to underscore and discuss a particular perspective on the masochistic phenomenon. Their study grew out of their clinical experience at the Austen Riggs Center in treating hospitalized patients who flagrantly inflicted suffering on themselves. The central theme developed by the contributors is that
for some individuals it appears that a masochistic life, however costly, represented their best possible effort at creating and maintaining a separate and autonomous sense of self. Their suffering salvaged for them a modicum of satisfaction, security, and self-esteem and thereby staved off the pull toward identity diffusion, psychotic regression, or suicide. (p. xiii)
The editors wrote about half the chapters themselves, and their view is consonant with the position of the other contributors. I will, therefore, comment on the book as a whole rather than focusing on the individual chapters. The several authors in this volume make their theoretical framework well known, and it is highlighted throughout. Winnicott's concepts about the holding environment and good enough mothering, and his developmental perspective, a particular view of countertransference phenomena and the therapeutic process, are clearly acknowledged and are central to the propositions put forth by the contributors to this book. The thinking of Balint, Mahler, Erikson, Kohut, and Stolorow are also liberally included and add substance to a perspective highly influenced by object relations theories and interpersonal processes. A chapter written by James Gorney and John Muller relies heavily on the work of Jacques Lacan.