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This collection of papers takes its title from a paper Nina Coltart gave in 1982 to the English-Speaking Psychoanalytic Conference, whose overall title was ‘Beyond Words’. The paper has become well known for the case vignette in which she reports shouting at a patient who had maintained a hateful silence for some time. Coltart tells us that this ‘act of freedom’ (Symington 1983) changed the course of the analysis, allowing a deeper understanding of a central dynamic in the patient's life. This paper, and the three other clinical papers (The Treatment of a Transvestite, The Silent Patient, and On the Tightrope) express Coltart's abiding interest in the ambiguities and challenges of psychoanalytic practice. These themes are repeated and elaborated in other papers in the book, some of which are lectures given to psychotherapy organisations.
In comparing the daily work of the analyst to the tightrope-walker, Coltart asserts her view that the most constant therapeutic factor is ‘unflagging attention’. The comparison itself I think conveys something quintessential in Coltart's approach her entirely personal, direct, lively, and sensitive way of thinking about psychoanalytic work. Her writings are clearly based on her clinical skills in understanding the subtleties of transference and countertransference dynamics.
She is also interested in the explicit and implicit moral and philosophical attitudes underpinning our work. The Tavistock Lecture entitled ‘Sin and the Superego: Man and his Conscience in Society’, and the paper on the practice of psychoanalysis and Buddhism are but two examples in this book.
Though the book at first reading appears to be quite a mixed collection of essays, it is throughout interesting and thought-provoking, always enjoyable to read.