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There is a growing trend in contemporary analytic theory that emphasizes the unique experience of the individual patient more than the discovery and communication of certain truths. In this way of thinking, the clinical encounter is more about the process, the engagement between patient and analyst, than a means for arriving at knowledge. The clinical music engages the patient's unique subjectivity, and the purpose of the process is to establish and expand the patient as a subject. Working with Trauma: Lessons from Bion and Lacan fits this evolution in analytic thought and extends it significantly by showing its utility for severely disturbed individuals.
Marilyn Charles' book is a deeply thoughtful, highly sensitive account of how a gifted clinician works with traumatized individuals. The book is a major contribution to psychoanalytic clinical theory on two levels. First, this volume is a seminal contribution to the psychotherapeutic treatment of severely disturbed individuals. Dr. Charles provides invaluable insights and guidelines for the psychoanalytic treatment of the most severely disturbed patients encountered by the clinician. In fact, the patients she uses to illustrate her clinical points suffer from the severe dysfunction that many clinicians dread working with and avoid if they can. In most mental health organizations psychotherapy is considered irrelevant and useless for such patients. In this age of medicalization of mental health treatment, Dr. Charles is among the few brave voices insisting on treating such patients with the respect and empathy that should be accorded all psychotherapy patients.
The second level is reflected in the subtitle, Lessons from Bion and Lacan. Charles demonstrates with utmost clarity and acuity the clinical usefulness of those two iconic, but enigmatic analytic theorists. Commonly regarded as interesting, innovative, even brilliant, minds, their influence in the U.S. has been minimal because many analysts regard their theoret