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Recounting the therapy of a severely regressed, psychotic patient, a brilliant woman writer in her 20s, Nakhla and Jackson's Picking Up The Pieces may be most highly recommended to therapists whose work focuses on neurotic conflict. In such a practice, there will inevitably be patients who can carry on a conventional analysis for years without being fully engaged. This book, covering the first three and a half years of a 16-year treatment, shows how such a stalemate may mean that the patient is going through the motions of analysis, “the false self” defending an amorphous and vulnerable true self hidden within. How such a psychotic core may be identified, brought to light, and given a chance to heal is described in a poignant case presentation. Interweaving a précis of relevant theoretical papers by such authors as Winnicott, Little, and Balint, Nakhla makes this brief book even more powerfully instructive.
Nakhla achieves clarity by dividing the narrative into eight chapters, each organized around the challenge of a particular phase of the treatment. The first, “Grace's Story,” written by the patient after her treatment, covers the period before she met Dr. Nakhla and includes her first therapy experience with an analyst in London