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Marilyn Charles's Working with Trauma: Lessons from Bion and Lacan is a wonderful text replete with wisdom for clinicians working with traumatized individuals. She aims to provide a readily useful book for clinicians who want to learn how to apply Bionian and Lacanian ideas to the consultation room. Charles's ability to convey her deep sensitivity and empathy for her patients communicates the pathos and humanism that animates her work. In many ways, it is reminiscent of Fromm-Reichmann's (1960) brilliant Principles of Intensive Psychotherapy, which is likewise full of clinical gems and commonsense insight informed by the best of psychodynamic thinking.
In her introduction, Charles outlines some of the important principles that guide her clinical work. Following Winnicott, Charles recognizes the limits of the therapist's power, and she warns against the therapist's need to be too helpful or too knowledgeable. Sometimes this desire actually robs the patient's sense of creativity and self-concern. Bion cautioned against trying to understand everything; instead he contended that the therapist's ability to tolerate the unknown could facilitate change. In the following chapter, Charles discusses the clinical utility of Lacan's idea of the subject caught by the desire of the other. She offers the example of a suicidal patient who expresses a death wish. This generally activates the therapist to combat and argue with the patient, attempting to convince the patient of the importance of life. Charles recommends that the therapist should sit with his or her ambivalence and should not attempt to impose his or her desires on the patient. Instead, the Lacanian intervention aims at inviting the patient to cast a critical gaze on his or her own desire, to allow the patient to see that