Psychoanalytic Understanding of Violence and Suicide edited by R. J. Perelberg and L. Shengold ( Routledge, London, 1998).  177 pp. £18.99.

This is an excellent book. It is the outcome of a research project at the Anna Freud Centre into analyses of physically violent patients and it substantially furthers our psychoanalytic understanding of patients who are affected by violent and suicidal fantasies. The main credit for the book (which is published in the New Library of Psychoanalysis series) goes to the book's co-editor, Rosine Perelberg, who has chosen her contributors well and who provides an outstanding literature review on the subject. Perelberg has also written a clinical chapter (Chapter 4), which deals with the analysis of a violent patient who held the unconscious belief that he was born of violent intercourse between himself and his mother. This fantasy had attained the status of belief: that is, it was thought to be true while simultaneously known to be false. The chapter also discusses issues of technique in the treatment of such patients. It is essential to understand that the patient's experience in the analysis is that they are attempting to survive in the face of what they experience as a terrifying object.

All the chapters of the book are of a high quality—a rare achievement. Peter Fonagy and Mary Target discuss a male patient who was deformed from birth and suffered from attacks of spinal pain. The patient complained violently if Fonagy did not say or do anything to reduce the patient's pain during the sessions, and this seemed to reflect the way in which the patient as a child had berated his mother. Fonagy's tolerance and analytic consistency enabled this persecuted and persecuting state of affairs to improve. This contrasted starkly with a representation of the mother in the transference as a resentful and rather ignorant person who viewed her child's problems with distaste, thereby exacerbating the patient's physical and mental distress.

Donald Campbell addresses the role of the father in a pre-suicidal state, and the use of attacks on the body to get rid of painful mental states. Ca